MEDICARE: SHEFALI SHAH M.D.

Medicare Provider Information

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	MD06572L	PA

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	080175948	OTHER	PA	RR MEDICARE

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	3968032	OTHER	PA	AETNA-HMO
3	20040361	OTHER	PA	MERCY
4	729782000	OTHER	PA	INDEPENDENCE BLUE CROSS
5	P006097	OTHER	PA	GATEWAY
6	PCP-000000128588	OTHER	PA	UNISON
7	5015114	OTHER	PA	AETNA-NON HMO
8	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
9	9376951	OTHER	PA	CIGNA
10	000977113	OTHER	PA	HIGHMARK
11	50055886	OTHER	PA	CAPITAL BLUE CROSS & KEYSTONE HEALTH PLAN CENTRAL

NPI Number	:	1659344273
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHEFALI SHAH M.D.

Provider Business Mailing Address
First Line	:	306 N 7TH ST
Second Line	:
City	:	COLUMBIA
State	:	PA
Zip	:	17512-2137
Country	:	US
Telephone Number	:	717-684-9106
Fax Number	:

Provider Business Practice Location Address
First Line	:	306 N 7TH ST
Second Line	:
City	:	COLUMBIA
State	:	PA
Zip	:	17512-2137
Country	:	US
Telephone Number	:	717-684-9106
Fax Number	:

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

Provider Enumeration Date	:	02/13/2006
Last Update Date	:	09/07/2010

306 N. SEVENTH STREET , STE 200
COLUMBIA, PA
17512-2137

Practice Phone: 717-684-9106
Practice Fax: 717-684-1666