Organization
PRINCETON UROLOGICAL GROUP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MIAN W SHAH MD (PRESIDENT)
(304) 425-3761
Entity
Organization
Contact information
Practice address
508 NEW HOPE RD, STE 207, PRINCETON, WV 24740-2264
(304) 425-3761
(304) 487-3654
Mailing address
508 NEW HOPE RD, STE 207, PRINCETON, WV 24740-2264
(304) 425-3761
(304) 487-3654
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0130754000
—
WV
Enumeration date
07/01/2006
Last updated
03/13/2013
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