Princeton Urological Group Inc

Primary specialty

Urology PhysicianTaxonomy code 208800000X

Legal business name

PRINCETON UROLOGICAL GROUP INC

Practice address

508 New Hope Rd
Ste 207
Princeton, WV 24740-2264

Phone

(304) 425-3761

Fax

(304) 487-3654

NPI assigned

Jul 1, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mian W Shah, MD

Title

President

Phone

(304) 425-3761

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1151712000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1363132800000",
    "number": "1821027905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "508 NEW HOPE RD",
            "address_2": "STE 207",
            "city": "PRINCETON",
            "state": "WV",
            "postal_code": "247402264",
            "telephone_number": "304-425-3761",
            "fax_number": "304-487-3654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "508 NEW HOPE RD",
            "address_2": "STE 207",
            "city": "PRINCETON",
            "state": "WV",
            "postal_code": "247402264",
            "telephone_number": "304-425-3761",
            "fax_number": "304-487-3654"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRINCETON UROLOGICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-01",
        "last_updated": "2013-03-13",
        "status": "A",
        "authorized_official_last_name": "SHAH",
        "authorized_official_first_name": "MIAN",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "304-425-3761",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Urology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0130754000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Princeton Pediatrics Lab
• Princeton Pediatrics, P.C.
• Princeton Psychological LLC
• Princeton Rescue Squad Inc
• Princeton Surgical Group Inc
• Priority One Home Care, LLC
• Jason L Pritchett, PHARMD
• Professional Imaging, Inc.
• Amy C Proffitt, MSN, FNP-BC
• Victoria Jean Proffitt

• Urology Physician in Princeton, WV
• Providers in Princeton, WV by specialty
• Urology Physician in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.