Provider Demographics
NPI:1336836253
Name:SHAH, DEVIN J
Entity type:Individual
Prefix:
First Name:DEVIN
Middle Name:J
Last Name:SHAH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 980257
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23298-0257
Mailing Address - Country:US
Mailing Address - Phone:804-828-9783
Mailing Address - Fax:
Practice Address - Street 1:VCUHS DEPT OF GENERAL SURGERY RESIDENCY
Practice Address - Street 2:1001 EAST LEIGH STREET
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23298-0257
Practice Address - Country:US
Practice Address - Phone:804-628-7497
Practice Address - Fax:804-827-1016
Is Sole Proprietor?:No
Enumeration Date:2023-04-20
Last Update Date:2024-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0116037913208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery