MEDICARE: DR. SHABBIR S. LAKDAWALA MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	MD037979L	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1093701591
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SHABBIR S. LAKDAWALA MD

Provider Business Mailing Address
First Line	:	2912 GLENMORE AVE
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15216-2042
Country	:	US
Telephone Number	:	412-563-1132
Fax Number	:	412-561-2117

Provider Business Practice Location Address
First Line	:	2912 GLENMORE AVE
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15216-2042
Country	:	US
Telephone Number	:	412-563-1132
Fax Number	:	412-561-2117

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/21/2005
Last Update Date	:	07/08/2007

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