Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | 0101263309 | VA |
N | 207R00000X | Internist | 0101263309 | VA |
N | 111NI0900X | Internist | 0101263309 | VA |
N | 207R00000X | Internist | LP02643 | RI |
N | 111NI0900X | Internist | LP02643 | RI |
NPI | 1033470091 |
---|---|
Provider Name | Shahab S Virani |
First Address | Fredericksburg, VA 22401-4654 |
Second Address | Fredericksburg, VA 22401-4654 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/06/2012 |
Last Update Date | 17/03/2018 |