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Supriya A Shah, MD
Student in an Organized Health Care Education/Training Program in Greenville, South Carolina
NPI 1689168460

Supriya A Shah is a Student in an Organized Health Care Education/Training Program based in Greenville, SC. Supriya A Shah practices in Greenville, SC and has the professional credentials of MD. The NPI Number for Supriya A Shah is 1689168460 and holds a License No. LL52600 (South Carolina).

The current practice location address for Supriya A Shah is 877 W Faris Rd, Greenville, SC and can be reached out via phone at 864-455-9022.

Location: 877 W Faris Rd, Greenville, SC, 29605-4289
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1689168460
Provider Name
Supriya A Shah
Credential
MD
Provider Entity Type
Individual
Gender
Female
Address
877 W Faris Rd, Greenville, SC, 29605-4289
Phone Number
864-455-9022
Fax Number
Provider Enumeration Date
06/15/2018
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
LL52600 01 SC STATE MEDICAL LICENSE
institution
Provider Business Practice Location Address Details
Address
877 W Faris Rd
City
Greenville
State
South Carolina
Zip
29605-4289
Phone Number
864-455-9022
Fax Number
person
Provider Business Mailing Address Details
Address
877 W Faris Rd
City
Greenville
State
South Carolina
Zip
29605-4289
Phone Number
864-455-9022
Fax Number
person
Provider's Taxonomy Details 1
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
LL52600 (South Carolina)
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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