MEDICARE: SARAH SHAHABUDDIN 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	207RP1001X	Pulmonary Disease Physician	0101231890	VA
2	207RS0012X	Sleep Medicine (Internal Medicine) Physician	0101231890	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	28581	OTHER	VA	CIGNA
2	4800892	OTHER	VA	UNITED HLTHCARE-MV
3	1014285	OTHER	VA	AETNA
4	154099	OTHER	VA	ANTHEM-RICHMOND
5	154100	OTHER	VA	ANTHEM-COLONIAL HEIGHTS
6	154101	OTHER	VA	ANTHEM-MECHANICSVILLE
7	184465	OTHER	VA	SOUTHERN HEALTH
8	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
9	4800408	OTHER	VA	UNITED HEALTHCARE-RICHMON
10	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
11	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
12	38371	OTHER	VA	CARENET
13	4800891	OTHER	VA	UNITED HEALTHCARE-CH

General Provider Information

NPI Number	:	1205827078
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARAH SHAHABUDDIN MD

Provider Business Mailing Address
First Line	:	PO BOX 8266
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23226-0266
Country	:	US
Telephone Number	:	804-285-0100
Fax Number	:	804-285-2458

Provider Business Practice Location Address
First Line	:	130 TEMPLE LAKE DR
Second Line	:	SUITE 5
City	:	COLONIAL HEIGHTS
State	:	VA
Zip	:	23834-4902
Country	:	US
Telephone Number	:	804-526-3450
Fax Number	:	804-520-1809

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

Provider Enumeration Date	:	11/02/2005
Last Update Date	:	04/30/2008

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