Healthcare Provider Details

I. General information

NPI: 1356549778
Provider Name (Legal Business Name): SHAILEN SHIVAM SEHGAL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/06/2007
Last Update Date: 03/08/2021
Certification Date: 03/08/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1145 BOWER HILL RD STE 105
PITTSBURGH PA
15243-1346
US

IV. Provider business mailing address

1000 BOWER HILL ROAD ST CLAIR HOSPITAL - AFFILIATE BILLING - PAMALYN
PITTSBURGH PA
15243-1873
US

V. Phone/Fax

Practice location:
  • Phone: 412-579-6194
  • Fax: 412-572-6195
Mailing address:
  • Phone: 412-942-2548
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License NumberMD443550
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: