MEDICARE: SHINETTE SIRMANS-MCRAE 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	207R00000X	Internal Medicine Physician	25MA07699300	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2022245	OTHER	PA	HIGHMARK BLUE SHIELD
2	3436078000	OTHER	PA	KEYSTONE HEALTH PLAN EAST
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	30060749	OTHER	PA	KEYSTONE MERCY-LOWER BUCKS GROUP

General Provider Information

NPI Number	:	1780601112
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHINETTE SIRMANS-MCRAE M.D.

Provider Business Mailing Address
First Line	:	14 BLOSSOM DR
Second Line	:
City	:	EWING
State	:	NJ
Zip	:	08638-2004
Country	:	US
Telephone Number	:	609-912-0180
Fax Number	:

Provider Business Practice Location Address
First Line	:	15 CAMPUS BLVD
Second Line	:
City	:	NEWTOWN SQUARE
State	:	PA
Zip	:	19073-3200
Country	:	US
Telephone Number	:	484-454-6262
Fax Number	:	610-789-6158

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

Provider Enumeration Date	:	07/15/2006
Last Update Date	:	06/15/2009

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