Individual
BASIL SHAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-0001
(336) 716-7243
(367) 167-4323
Mailing address
MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-0001
(336) 716-7243
(336) 716-7432
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
4301077845
MI
207T00000X
Neurological Surgery Physician
22774
MS
2085R0202X
Diagnostic Radiology Physician
Primary
0101269688
VA
2085R0202X
Diagnostic Radiology Physician
2020-02857
NC
2085R0204X
Vascular & Interventional Radiology Physician
22774
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00188398
MS MEDICAID
—
01
—
107229
AL MEDICAID
LA
Enumeration date
08/31/2006
Last updated
03/31/2026
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