MEDICARE: SHAKEEL AMANULLAH 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	174400000X	Specialist	MD422116	PA
2	207RC0200X	Critical Care Medicine (Internal Medicine) Physician	01064290A	IN

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	000000531300	OTHER	IN	ANTHEM PROVIDER NUMBER
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1629049036
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHAKEEL AMANULLAH MD

Provider Business Mailing Address
First Line	:	540 N DUKE ST
Second Line	:	SUITE 244
City	:	LANCASTER
State	:	PA
Zip	:	17602-2374
Country	:	US
Telephone Number	:	717-544-7679
Fax Number	:	717-544-4964

Provider Business Practice Location Address
First Line	:	540 N DUKE ST
Second Line	:	SUITE 244
City	:	LANCASTER
State	:	PA
Zip	:	17602-2374
Country	:	US
Telephone Number	:	717-544-4930
Fax Number	:	717-544-4964

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

Provider Enumeration Date	:	02/01/2006
Last Update Date	:	03/15/2024

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Directions to “ SHAKEEL AMANULLAH MD” Practice Location

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