Provider Demographics
| NPI: | 1336313717 |
|---|---|
| Name: | SHAH, PALAK (MD, MS) |
| Entity type: | Individual |
| Prefix: | DR |
| First Name: | PALAK |
| Middle Name: | |
| Last Name: | SHAH |
| Suffix: | |
| Gender: | M |
| Credentials: | MD, MS |
| Other - Prefix: | |
| Other - First Name: | |
| Other - Middle Name: | |
| Other - Last Name: | |
| Other - Suffix: | |
| Other - Last Name Type: | |
| Other - Credentials: | |
| Mailing Address - Street 1: | 3300 GALLOWS ROAD |
| Mailing Address - Street 2: | TRANSPLANT PROGRAM - IHVI |
| Mailing Address - City: | FALLS CHURCH |
| Mailing Address - State: | VA |
| Mailing Address - Zip Code: | 22042 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 703-776-7075 |
| Mailing Address - Fax: | |
| Practice Address - Street 1: | 3300 GALLOWS RD |
| Practice Address - Street 2: | |
| Practice Address - City: | FALLS CHURCH |
| Practice Address - State: | VA |
| Practice Address - Zip Code: | 22042-3307 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 703-776-7075 |
| Practice Address - Fax: | |
| Is Sole Proprietor?: | No |
| Enumeration Date: | 2008-04-17 |
| Last Update Date: | 2023-11-27 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Licenses
| State | License ID | Taxonomies |
|---|---|---|
| VA | 0101242687 | 207RA0001X |
| MI | 4301100466 | 207R00000X, 207RC0000X |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization |
|---|---|---|---|---|
| Yes | 207RC0000X | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease |
| Yes | 207RA0001X | Allopathic & Osteopathic Physicians | Internal Medicine | Advanced Heart Failure and Transplant Cardiology |
| No | 207R00000X | Allopathic & Osteopathic Physicians | Internal Medicine |