MEDICARE: SHAFIC Y TWAL M.D.

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	208000000X	Pediatrics Physician	MD020149E	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	848902	OTHER	PA	HIGHMARK
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1104811819
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHAFIC Y TWAL M.D.

Provider Business Mailing Address
First Line	:	15 S 8TH ST
Second Line	:	SUITE 200
City	:	INDIANA
State	:	PA
Zip	:	15701-2776
Country	:	US
Telephone Number	:	724-463-0476
Fax Number	:	724-463-1196

Provider Business Practice Location Address
First Line	:	15 S 8TH ST
Second Line	:	SUITE 200
City	:	INDIANA
State	:	PA
Zip	:	15701-2776
Country	:	US
Telephone Number	:	724-463-0476
Fax Number	:	724-463-1196

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/19/2005
Last Update Date	:	07/08/2007

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Directions to “ SHAFIC Y TWAL M.D.” Practice Location

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