Individual
GERTRUDE K SHAHADY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
925 VILLAGE HWY, RUSTBURG, VA 24588-4591
(434) 332-7367
(434) 332-1757
Mailing address
PO BOX 69, RUSTBURG, VA 24588-0069
(434) 332-7367
(434) 332-1757
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101229867
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
005644526
—
VA
01
—
080186503
MEDICARE RAILROAD
VA
01
—
0907130004
DME RUSTBURG
VA
05
—
1487639878
—
VA
01
—
460635
ANTHEM
—
Enumeration date
12/08/2005
Last updated
08/13/2013
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