MEDICARE: VIJI SHANKAR M.D.

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	208100000X	Physical Medicine & Rehabilitation Physician	MD437333	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	:	1194911727
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VIJI SHANKAR M.D.

Provider Business Mailing Address
First Line	:	1220 LINCOLN WAY
Second Line	:	SUITE 102
City	:	WHITE OAK
State	:	PA
Zip	:	15131-1642
Country	:	US
Telephone Number	:	412-673-0502
Fax Number	:

Provider Business Practice Location Address
First Line	:	1220 LINCOLN WAY
Second Line	:	SUITE 102
City	:	WHITE OAK
State	:	PA
Zip	:	15131-1642
Country	:	US
Telephone Number	:	412-673-0502
Fax Number	:

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

Provider Enumeration Date	:	09/18/2007
Last Update Date	:	10/20/2011

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