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Individual

DR. SHAHLA VAKILI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
1500 LOCUST STREET, PHILADELPHIA, PA 19102
(610) 331-6942
(215) 875-8324
Mailing address
5401 OLD YORK ROAD, KLEIN 401, PHILADELPHIA, PA 19141-3030
(215) 456-7190
(215) 456-5926

Taxonomy

Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
1860
DE
2084N0400X
Neurology Physician
Primary
MD43311
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100853575000
PA
Enumeration date
11/29/2006
Last updated
04/04/2016
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