Provider Demographics
NPI:1124306568
Name:SHAH, VIRANG GIRISH (DPM)
Entity type:Individual
Prefix:DR
First Name:VIRANG
Middle Name:GIRISH
Last Name:SHAH
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3925 JOHNS CREEK CT
Mailing Address - Street 2:SUITE C2
Mailing Address - City:SUWANEE
Mailing Address - State:GA
Mailing Address - Zip Code:30024-6618
Mailing Address - Country:US
Mailing Address - Phone:315-882-1200
Mailing Address - Fax:
Practice Address - Street 1:3925 JOHNS CREEK CT
Practice Address - Street 2:SUITE C2
Practice Address - City:SUWANEE
Practice Address - State:GA
Practice Address - Zip Code:30024-6618
Practice Address - Country:US
Practice Address - Phone:315-882-1200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-03
Last Update Date:2015-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPOD001250213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery