Provider Demographics
NPI:1215147905
Name:SHIVA, RUPA (MBBS)
Entity type:Individual
Prefix:
First Name:RUPA
Middle Name:
Last Name:SHIVA
Suffix:
Gender:F
Credentials:MBBS
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:NASA MARSHALL SPACE FLIGHT CENTER
Mailing Address - Street 2:AS10 BUILDING 4249
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35812-3581
Mailing Address - Country:US
Mailing Address - Phone:565-445-7312
Mailing Address - Fax:256-544-5743
Practice Address - Street 1:NASA MARSHALL SPACE FLIGHT CENTER
Practice Address - Street 2:AS10 BUILDING 4249
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35812-3581
Practice Address - Country:US
Practice Address - Phone:256-544-5731
Practice Address - Fax:256-544-5743
Is Sole Proprietor?:No
Enumeration Date:2007-05-23
Last Update Date:2023-12-15
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Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ALL2630207Q00000X
AL28819207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine