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General NPI Number Information
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NPI Number | 1801098835
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Entity Type | Organization
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Legal Business Name | PANHANDLE GASTROENTEROLOGY, PLLC
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Dates
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Enumeration Date | 06/01/2007
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Last Update Date | 09/25/2014
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Provider Practice Location Address
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Address Line | 2000 FOUNDATION WAY SUITE 3500
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City | MARTINSBURG
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State | WV
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Zip | 25401-9583
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Country | US
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Telephone | 304-260-0160
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Fax | 304-260-0162
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Provider Business Mailing Address
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Address Line | 2000 FOUNDATION WAY SUITE 3500
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City | MARTINSBURG
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State | WV
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Zip | 25401-9583
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Country | US
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Telephone | 304-260-0160
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Fax | 304-260-0162
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Authorized Official
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Title or Position | OWNER
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Name | DR. SHAHIN M RAHIMIAN
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Credential | D.O.
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Telephone | 304-260-0160
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 2108
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License Number State | WV
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