Healthcare Provider Details

I. General information

NPI: 1013182146
Provider Name (Legal Business Name): SHAHEEN TIMMAPURI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/29/2008
Last Update Date: 02/09/2026
Certification Date: 02/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 OSTRUM ST STE 102
FOUNTAIN HILL PA
18015-1152
US

IV. Provider business mailing address

701 OSTRUM ST STE 102
FOUNTAIN HILL PA
18015-1152
US

V. Phone/Fax

Practice location:
  • Phone: 484-658-5437
  • Fax: 833-679-4147
Mailing address:
  • Phone: 484-658-5437
  • Fax: 833-679-4147

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0120X
TaxonomyPediatric Surgery Physician
License NumberMD421653
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: