Individual
RAHMAT SHAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
700 QUINCY AVE, SCRANTON, PA 18510-1724
(570) 770-6469
(570) 770-6476
Mailing address
3998 FAIR RIDGE DRIVE, SUITE 300, FAIRFAX, VA 22033-2921
(703) 295-9360
(703) 766-9725
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
MD016125E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000955920007
—
PA
01
—
050015096
RR MEDICARE
PA
Enumeration date
12/19/2005
Last updated
03/02/2015
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