MEDICARE: SHAKER URGENT CARE PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QU0200X	Urgent Care Clinic/Center

General Provider Information

NPI Number	:	1003197906
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SHAKER URGENT CARE PC

Provider Business Mailing Address
First Line	:	308 BESSEMER RD
Second Line	:
City	:	MT PLEASANT
State	:	PA
Zip	:	15666-9134
Country	:	US
Telephone Number	:	724-542-4321
Fax Number	:	724-542-4298

Provider Business Practice Location Address
First Line	:	308 BESSEMER RD
Second Line	:
City	:	MT PLEASANT
State	:	PA
Zip	:	15666-9134
Country	:	US
Telephone Number	:	724-542-4321
Fax Number	:	724-542-4298

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MILAD SHAKER
Credential	:	MD
Telephone Number	:	724-542-4321

Provider Enumeration Date	:	09/06/2011
Last Update Date	:	09/09/2011

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