MEDICARE: HASEEBA SHAHZAD 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	207R00000X	Internal Medicine Physician	36141572	IL
2	207R00000X	Internal Medicine Physician	26545	WV
3	207RX0202X	Medical Oncology Physician	35.134294	OH
4	207RH0003X	Hematology & Oncology Physician	MD484824	PA

General Provider Information

NPI Number	:	1770849812
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HASEEBA SHAHZAD M.D.

Provider Business Mailing Address
First Line	:	200 ST LUKES LN
Second Line	:
City	:	STROUDSBURG
State	:	PA
Zip	:	18360-6218
Country	:	US
Telephone Number	:	484-503-4673
Fax Number	:

Provider Business Practice Location Address
First Line	:	200 ST LUKES LN
Second Line	:
City	:	STROUDSBURG
State	:	PA
Zip	:	18360-6218
Country	:	US
Telephone Number	:	484-503-4673
Fax Number	:

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

Provider Enumeration Date	:	04/03/2012
Last Update Date	:	01/14/2026

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