Healthcare Provider Details

I. General information

NPI: 1952605578
Provider Name (Legal Business Name): SAMIRKUMAR J SHAH MD, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/23/2010
Last Update Date: 02/02/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1360 OLD FREEPORT RD SUITE 1A
PITTSBURGH PA
15238-4102
US

IV. Provider business mailing address

1360 OLD FREEPORT RD SUITE 1A
PITTSBURGH PA
15238
US

V. Phone/Fax

Practice location:
  • Phone: 412-963-2349
  • Fax: 412-963-7568
Mailing address:
  • Phone: 412-963-2349
  • Fax: 412-963-7568

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code173000000X
TaxonomyLegal Medicine
License NumberMD050641L
License Number StatePA

VIII. Authorized Official

Name: DR. SAMIRKUMAR J SHAH
Title or Position: OWNER
Credential: MD FACC
Phone: 412-963-2349