Provider Demographics
NPI:1558432393
Name:SHAH, JOHAR ALI (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHAR
Middle Name:ALI
Last Name:SHAH
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1803 MT ROSE AVE
Mailing Address - Street 2:STE B3
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17403-3051
Mailing Address - Country:US
Mailing Address - Phone:717-851-1405
Mailing Address - Fax:717-339-2711
Practice Address - Street 1:40 V TWIN DR
Practice Address - Street 2:STE 202
Practice Address - City:GETTYSBURG
Practice Address - State:PA
Practice Address - Zip Code:17325-1926
Practice Address - Country:US
Practice Address - Phone:717-339-2710
Practice Address - Fax:717-339-2711
Is Sole Proprietor?:No
Enumeration Date:2006-11-13
Last Update Date:2012-02-15
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Provider Licenses
StateLicense IDTaxonomies
PAMD4298252084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA101858610Medicaid
PA101858610Medicaid