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General NPI Number Information
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NPI Number | 1285600593
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Entity Type | Individual
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Provider Name | SAMIR SUNIL SHAH MD
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Gender | Male
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Dates
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Enumeration Date | 02/27/2006
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Last Update Date | 04/29/2025
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Provider Practice Location Address
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Address Line | 3400 SPRUCE STREET
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City | PHILADELPHIA
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State | PA
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Zip | 19104-4206
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Country | US
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Telephone | 215-662-3000
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Fax | 215-662-7011
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Provider Business Mailing Address
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Address Line | 22 LLANFAIR RD UNIT 6
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City | ARDMORE
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State | PA
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Zip | 19003-2320
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Country | US
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Telephone | 215-662-3000
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Fax | 215-662-7011
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | MD424458
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License Number State | PA
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