Individual
DR. GHAZANFAR A SHAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
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
2085N0904X
Nuclear Radiology Physician
MD021477E
PA
2085R0202X
Diagnostic Radiology Physician
Primary
MD021477E
PA
2085R0204X
Vascular & Interventional Radiology Physician
MD021477E
PA
2085U0001X
Diagnostic Ultrasound Physician
MD021477E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0014331420001
ION HEALTH
—
05
—
0014331420001
—
PA
01
—
020636100
BLACK LUNG CLASS
—
01
—
099132
BLUE SHIELD CLASS
—
01
—
1462168
UMWA CLASS
—
01
—
206361
BLACK LUNG DETERMIN
—
01
—
300036814
RR MEDICARE CLASS
—
01
—
30006409
KEYSTONE MERCY CLASS
—
01
—
39972
GEISINGER CLASS
—
01
—
P022732
TRICARE CLASS
—
Enumeration date
12/08/2005
Last updated
10/03/2011
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