MEDICARE: SYED MOEZ SHAH BUKHARI

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	MD467914	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

General Provider Information

NPI Number	:	1821440850
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SYED MOEZ SHAH BUKHARI

Provider Business Mailing Address
First Line	:	3509 N BROAD ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19140-4105
Country	:	US
Telephone Number	:	215-707-3133
Fax Number	:

Provider Business Practice Location Address
First Line	:	CLEVELAND CLINIC 9500 EUCLID AVENUE/JJ24
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44195-2442
Country	:	US
Telephone Number	:	216-444-2200
Fax Number	:	215-214-4119

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

Provider Enumeration Date	:	07/01/2016
Last Update Date	:	02/05/2026

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