Provider Demographics
NPI:1629389887
Name:SHAH, NIRAVKUMAR (PT, DPT)
Entity type:Individual
Prefix:
First Name:NIRAVKUMAR
Middle Name:
Last Name:SHAH
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:NIRAV
Other - Middle Name:
Other - Last Name:SHAH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:6650 RIVERS AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:N CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29406-4809
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6650 RIVERS AVE STE 100
Practice Address - Street 2:
Practice Address - City:N CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29406-4809
Practice Address - Country:US
Practice Address - Phone:803-220-5785
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-23
Last Update Date:2025-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP21133225100000X
SC12600225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist