Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RE0101X | Endocrinologist (Diabetes Doctor) | 0101272210 | VA |
NPI | 1093162059 |
---|---|
Provider Name | Manasi Sanjiv Shah |
First Address | Norfolk, VA 23510-1005 |
Second Address | Norfolk, VA 23510-1005 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/05/2016 |
Last Update Date | 16/09/2021 |