Provider Demographics
NPI:1487679593
Name:SHAH, SATISH A (MD)
Entity Type:Individual
Prefix:DR
First Name:SATISH
Middle Name:A
Last Name:SHAH
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 1:20 EXPEDITION TRL
Mailing Address - Street 2:SUITE 101
Mailing Address - City:GETTYSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17325-8598
Mailing Address - Country:US
Mailing Address - Phone:717-334-4033
Mailing Address - Fax:717-334-5599
Practice Address - Street 1:20 EXPEDITION TRL
Practice Address - Street 2:SUITE 101
Practice Address - City:GETTYSBURG
Practice Address - State:PA
Practice Address - Zip Code:17325-8598
Practice Address - Country:US
Practice Address - Phone:717-334-4033
Practice Address - Fax:717-334-5599
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-12
Last Update Date:2016-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD039646L207RH0003X
MDD0036147207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0011597790001Medicaid
PA0011597790001Medicaid
PAC31963Medicare UPIN