MEDICARE: MILAD ISHAK SHAKER MD

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	207Q00000X	Family Medicine Physician	MD437512	PA

General Provider Information

NPI Number	:	1114184124
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MILAD ISHAK SHAKER MD

Provider Business Mailing Address
First Line	:	308 BESSEMER RD
Second Line	:	STE 100
City	:	MOUNT PLEASANT
State	:	PA
Zip	:	15666-9134
Country	:	US
Telephone Number	:	724-542-4296
Fax Number	:	724-542-4298

Provider Business Practice Location Address
First Line	:	308 BESSEMER RD
Second Line	:	SUITE 100
City	:	MOUNT PLEASANT
State	:	PA
Zip	:	15666-9134
Country	:	US
Telephone Number	:	724-542-4296
Fax Number	:	724-542-4298

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

Provider Enumeration Date	:	05/19/2008
Last Update Date	:	02/06/2014

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