MEDICARE: DUBOIS RADIOLOGISTS INC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number State
1	2085N0904X	Nuclear Radiology Physician	PA
2	2085R0202X	Diagnostic Radiology Physician	PA
3	2085R0204X	Vascular & Interventional Radiology Physician	PA
4	2085U0001X	Diagnostic Ultrasound Physician	PA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	456199	OTHER		MEDICARE CLASS

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	2493	OTHER	GEISINGER CLASS
2	456199	OTHER	BLUE SHIELD CLASS
4	P022732	OTHER	TRICARE CLASS
5	0014329870007	OTHER	ION HEALTH
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1700860517
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DUBOIS RADIOLOGISTS INC

Provider Business Mailing Address
First Line	:	PO BOX 1106
Second Line	:
City	:	DU BOIS
State	:	PA
Zip	:	15801-0906
Country	:	US
Telephone Number	:	814-371-1784
Fax Number	:	814-371-4812

Provider Business Practice Location Address
First Line	:	100 HOSPITAL AVE
Second Line	:
City	:	DU BOIS
State	:	PA
Zip	:	15801-1440
Country	:	US
Telephone Number	:	814-371-1784
Fax Number	:	814-371-4812

Authorized Official
Title or Position	:	PRESIDENT
Name	:	GHAZANFAR A SHAH
Credential	:	MD
Telephone Number	:	814-375-3261

Provider Enumeration Date	:	12/05/2005
Last Update Date	:	09/11/2025

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Directions to “DUBOIS RADIOLOGISTS INC ” Practice Location

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