MEDICARE: GEITH H SHAHOUD 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	2084P0800X	Psychiatry Physician	2004009710	MO
2	2084P0800X	Psychiatry Physician	MD423515	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1346229291
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GEITH H SHAHOUD MD

Provider Business Mailing Address
First Line	:	111 ROBERTS RD STE 150
Second Line	:
City	:	GRINDSTONE
State	:	PA
Zip	:	15442-2104
Country	:	US
Telephone Number	:	724-785-4346
Fax Number	:	724-364-7117

Provider Business Practice Location Address
First Line	:	111 ROBERTS RD STE 150
Second Line	:
City	:	GRINDSTONE
State	:	PA
Zip	:	15442-2104
Country	:	US
Telephone Number	:	724-785-4346
Fax Number	:	724-364-7117

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

Provider Enumeration Date	:	01/10/2006
Last Update Date	:	03/18/2025

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Directions to “ GEITH H SHAHOUD MD” Practice Location

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