Organization
MEDICAL PRACTICE, LTD.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DHARMESH K SHAH M.D. (PRESIDENT)
(757) 543-6861
Entity
Organization
Contact information
Practice address
710 LIBERTY ST, CHESAPEAKE, VA 23324-2637
(757) 543-6861
(757) 543-4082
Mailing address
710 LIBERTY ST, CHESAPEAKE, VA 23324-2637
(757) 543-6861
(757) 543-4082
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0101023718
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110138225
MEDICARE-RAILROAD
VA
01
—
12090
OPTIMA HEALTH
VA
01
—
461191
ANTHEM
VA
05
—
5882401
—
VA
Enumeration date
12/15/2006
Last updated
09/29/2014
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