Individual
MR. KETAN R SHAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
3200 TYRE NECK RD, SUITE 101, PORTSMOUTH, VA 23703-3329
(757) 399-7451
(757) 399-1158
Mailing address
3200 TYRE NECK RD, SUITE 101, PORTSMOUTH, VA 23703-3329
(757) 399-7451
(757) 399-1158
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
0024169375
VA
367500000X
Certified Registered Nurse Anesthetist
APRN9431447
FL
Other
Enumeration date
05/05/2011
Last updated
02/19/2025
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