Individual
DR. MEHUL JITENDRA SHAH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
224A CORNWALL ST NW, LOUDOUN COMMUNITY HEALTH CENTER, LEESBURG, VA 20176-2701
(703) 443-2120
(703) 443-2033
Mailing address
PO BOX 616, ASHBURN, VA 20146-0616
(703) 443-2120
Taxonomy
Speciality
Code
Description
License number
State
213EP1101X
Primary Podiatric Medicine Podiatrist
0103300893
VA
213ES0000X
Sports Medicine Podiatrist
0103300893
VA
213ES0131X
Foot Surgery Podiatrist
Primary
0103300893
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1841465291
GROUP NPI
VA
01
—
350392
ANTHEM BC/BS
VA
01
—
3854800
CIGNA
VA
01
—
7980784
AETNA
VA
01
—
J4630001
CAREFIRST BC/BS
VA
Enumeration date
02/27/2006
Last updated
01/21/2012
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