Individual
DR. MIKESH C SHAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
390 S MAIN ST, SUITE 201, ROCKY MOUNT, VA 24151-1711
(540) 484-4800
(540) 484-4882
Mailing address
2740 CHATEAU CT, ROANOKE, VA 24012-6782
(540) 977-4589
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0101238418
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010190495
—
VA
05
—
010243947
—
VA
05
—
010318912
—
VA
Enumeration date
11/11/2005
Last updated
03/05/2012
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