Provider Demographics
NPI:1346417730
Name:TAHIR, PSHTIWAN A (MD)
Entity Type:Individual
Prefix:
First Name:PSHTIWAN
Middle Name:A
Last Name:TAHIR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:933 CRESTWOOD DR
Mailing Address - Street 2:
Mailing Address - City:CHAMBERSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17202-4605
Mailing Address - Country:US
Mailing Address - Phone:717-446-3018
Mailing Address - Fax:
Practice Address - Street 1:112 N 7TH ST
Practice Address - Street 2:
Practice Address - City:CHAMBERSBURG
Practice Address - State:PA
Practice Address - Zip Code:17201-1720
Practice Address - Country:US
Practice Address - Phone:717-217-4300
Practice Address - Fax:717-217-4217
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-14
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD437988207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA9263404OtherAETNA NON-HMO
PA1007307260034OtherMEDICAID GROUP #
PAMD437988OtherMEDICAL LICENCE
PAP00768398OtherRAILROAD MEDICARE
PA120420410OtherDEPT OF LABOR
PA25-1716306OtherINFORMED
PA25-1716306OtherHEALTHNET/TRICARE
PA25-1716306OtherSOUTH CENTRAL PREFERRED
PA50088509OtherCAPITAL BLUECROSS
PATA2123270OtherHIGHMARK BLUESHIELD
PA1346417730OtherHEALTH AMERICA
PA1585291OtherGATEWAY
PA102372750 0001Medicaid
PA102372750 0002Medicaid
PA25-1716306OtherINTERGROUP
PA25-1716306OtherGREATWEST HEALTHCARE
PA2507285OtherMAMSI GROUP # (WH)
PA289493OtherUNISON
PA867633OtherMEDICARE GROUP #
PA6024884OtherAETNA HMO
PA1346417730OtherFIRST HEALTH
PA2183091OtherMAMSI GROUP # (CH)
PA25-1716306OtherMULTIPLAN/PHCS
PA25-1716306OtherDEVON
PA25-1716306OtherDEVON
PA867633OtherMEDICARE GROUP #