Provider Demographics
NPI:1922636711
Name:SHAH, TULSI SHAILESH (MD)
Entity type:Individual
Prefix:DR
First Name:TULSI
Middle Name:SHAILESH
Last Name:SHAH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6862 ELM ST STE 450
Mailing Address - Street 2:
Mailing Address - City:MC LEAN
Mailing Address - State:VA
Mailing Address - Zip Code:22101-3838
Mailing Address - Country:US
Mailing Address - Phone:301-339-8027
Mailing Address - Fax:
Practice Address - Street 1:6862 ELM ST STE 450
Practice Address - Street 2:
Practice Address - City:MC LEAN
Practice Address - State:VA
Practice Address - Zip Code:22101-3838
Practice Address - Country:US
Practice Address - Phone:301-339-8027
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-29
Last Update Date:2025-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01012819772084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology