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Individual

VIPUL INDULAL SHAH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1203 E CHEVES ST, FLORENCE, SC 29506-2711
(843) 777-5601
(843) 777-5135
Mailing address
1203 E CHEVES ST, FLORENCE, SC 29506-2711
(843) 777-2564
(843) 537-2262

Taxonomy

Speciality
Code
Description
License number
State
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
Primary
31225
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000246527
UNISON
SC
01
064
BLUECHOICE
SC
01
211192
MEDCOST
SC
05
312254
SC
05
5910037
NC
01
9690217
AETNA
SC
01
AA30388552
MEDICARE PTAN
SC
Enumeration date
05/14/2007
Last updated
12/04/2023
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