MEDICARE: DR. MITCHELL CAREY SHIRAH 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	207Q00000X	Family Medicine Physician	9705	AL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	P00181558	OTHER		RAILROAD MEDICARE
4	000010937	OTHER		MEDICARE

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
2	51525162	OTHER	AL	BCBS OF AL

General Provider Information

NPI Number	:	1902889371
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MITCHELL CAREY SHIRAH M.D.

Provider Business Mailing Address
First Line	:	59664 HIGHWAY 22
Second Line	:
City	:	ROANOKE
State	:	AL
Zip	:	36274-4438
Country	:	US
Telephone Number	:	334-863-8952
Fax Number	:	334-863-2361

Provider Business Practice Location Address
First Line	:	59664 HIGHWAY 22
Second Line	:
City	:	ROANOKE
State	:	AL
Zip	:	36274-4438
Country	:	US
Telephone Number	:	334-863-8952
Fax Number	:	334-863-2361

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

Provider Enumeration Date	:	11/21/2005
Last Update Date	:	03/29/2013

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Directions to “ DR. MITCHELL CAREY SHIRAH M.D.” Practice Location

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