Provider Demographics
NPI:1346400751
Name:NARAYANA, SHYAM (MBBS, MPH)
Entity Type:Individual
Prefix:DR
First Name:SHYAM
Middle Name:
Last Name:NARAYANA
Suffix:
Gender:M
Credentials:MBBS, MPH
Other - Prefix:
Other - First Name:SHYAM
Other - Middle Name:
Other - Last Name:NARAYANA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 858
Mailing Address - Street 2:MC A410
Mailing Address - City:HERSHEY
Mailing Address - State:PA
Mailing Address - Zip Code:17033-0858
Mailing Address - Country:US
Mailing Address - Phone:800-243-1455
Mailing Address - Fax:
Practice Address - Street 1:500 UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:HERSHEY
Practice Address - State:PA
Practice Address - Zip Code:17033-2360
Practice Address - Country:US
Practice Address - Phone:717-531-8395
Practice Address - Fax:717-531-5726
Is Sole Proprietor?:No
Enumeration Date:2008-06-10
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003836207RE0101X
PAMD446323207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1028750800001Medicaid
PA268131OtherMEDICARE