Individual
ANSAL SHAH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1 RICHLAND MEDICAL PARK, SUITE 420, COLUMBIA, SC 29203-6833
(803) 545-5350
(803) 545-5353
Mailing address
PO BOX 743904, ATLANTA, GA 30374-3904
(803) 293-7320
(803) 296-7330
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
37267
SC
207R00000X
Internal Medicine Physician
MD446549
PA
207RI0200X
Infectious Disease Physician
Primary
37267
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
37267
MEDICAL LICENSE
SC
05
—
372670
—
SC
Enumeration date
03/12/2012
Last updated
03/15/2018
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