Individual
SUSAN SHAMIMI-NOORI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
111 S 11TH ST, STE 3390, PHILADELPHIA, PA 19107-4824
(215) 955-6226
(215) 923-1562
Mailing address
3400 SPRUCE STREET, PHILADELPHIA, PA 19104
(215) 662-3000
(215) 662-7011
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MT190897
PA
2085R0202X
Diagnostic Radiology Physician
MD449422
PA
2085R0204X
Vascular & Interventional Radiology Physician
Primary
MD449422
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0364941
—
NJ
05
—
102847245
—
PA
Enumeration date
08/28/2007
Last updated
06/02/2017
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