Organization
SAMIR SHAH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SAMIR J. SHAH M.D. (PROPRIETOR)
(724) 545-3417
Entity
Organization
Contact information
Practice address
401 PINE HILL RD, KITTANNING, PA 16201-4433
(724) 545-3417
(724) 543-3744
Mailing address
401 PINE HILL RD, KITTANNING, PA 16201-4433
(724) 545-3417
(724) 543-3744
Taxonomy
Speciality
Code
Description
License number
State
173000000X
Legal Medicine
Primary
MD050641L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1035606
GATEWAY
PA
01
—
1790753739
TYPE 1 NPI
PA
Enumeration date
04/20/2007
Last updated
12/10/2010
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