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Individual

RAINA SHIVASHANKAR

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
1101 CHESTNUT ST, PHILADELPHIA, PA 19107-3612
(215) 955-8900
(215) 923-3447
Mailing address
132 S 10TH ST, 480 MAIN BUILDING, PHILADELPHIA, PA 19107-5244
(215) 955-8900
(215) 923-3447

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
54258
MN
207RG0100X
Gastroenterology Physician
54258
MN
207RG0100X
Gastroenterology Physician
Primary
MD456659
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
P01105546
MEDICARE RAILROAD
MN
Enumeration date
06/17/2010
Last updated
10/28/2024
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