Organization
RAINTREE MRI SERVICES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GHAZANFAR A SHAH MD (PRESIDENT)
(814) 375-3261
Entity
Organization
Contact information
Practice address
100 HOSPITAL AVE, DU BOIS, PA 15801-1440
(814) 371-1784
(814) 371-4812
Mailing address
PO BOX 1106, DU BOIS, PA 15801-0906
(814) 371-1784
(814) 371-4812
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0015335220008
—
PA
01
—
4348
GEISINGER CLASS
—
01
—
641205
BLUE SHIELD CLASS
—
01
—
P029588
TRICARE CLASS
—
Enumeration date
12/05/2005
Last updated
04/20/2008
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