Healthcare Provider Details

I. General information

NPI: 1013605054
Provider Name (Legal Business Name): GHULAM SHAHAR BANO M.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/27/2023
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2570 HAYMAKER RD
MONROEVILLE PA
15146
US

IV. Provider business mailing address

2570 HAYMAKER RD
MONROEVILLE PA
15146-3513
US

V. Phone/Fax

Practice location:
  • Phone: 412-664-2782
  • Fax:
Mailing address:
  • Phone: 412-858-7618
  • Fax: 412-858-7628

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberMD496080
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD496080
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: