Organization
SORAYA, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROMIN BHARAT SHAH MD (OWNER)
(864) 254-9487
Entity
Organization
Contact information
Practice address
25 APPIAN CIR, SIMPSONVILLE, SC 29681-3654
(864) 254-9487
(864) 254-9487
Mailing address
68 GLOBAL DR, SUITE 100, GREENVILLE, SC 29607-4628
(864) 644-2700
(864) 644-2709
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
31626
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
31626
MD LICENSE
SC
Enumeration date
08/05/2010
Last updated
10/28/2010
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