Provider Demographics
NPI:1235592379
Name:SHUKLA, SAVYA S (MD)
Entity Type:Individual
Prefix:DR
First Name:SAVYA
Middle Name:S
Last Name:SHUKLA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 7623
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34101-7623
Mailing Address - Country:US
Mailing Address - Phone:305-712-7229
Mailing Address - Fax:305-397-1139
Practice Address - Street 1:100 NORTH ACADEMY AVE
Practice Address - Street 2:DANVILLE, PA 17822
Practice Address - City:DANVILLE
Practice Address - State:PA
Practice Address - Zip Code:17822-9800
Practice Address - Country:US
Practice Address - Phone:570-271-6301
Practice Address - Fax:570-271-5976
Is Sole Proprietor?:No
Enumeration Date:2016-04-05
Last Update Date:2023-12-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME1419612085R0202X
PAMD4816052085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLJ5FWFOtherFLORIDA BLUE (BCBS)
FL15190378OtherCAQH
FLQ00200896OtherFLORIDA RAILROAD MEDICARE
FLN8375OtherFLORIDA MEDICARE
FL112241900Medicaid