Individual
SAMANTHA RAO SHAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD173772
OR
207R00000X
Internal Medicine Physician
MD424815
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080097556
RAILROAD MEDICARE
PA
05
—
1015043540001
—
PA
05
—
500692604
—
OR
01
—
597586
MEDICARE GROUP
PA
Enumeration date
12/01/2005
Last updated
01/14/2021
Update your record
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