Provider Demographics
NPI:1568435725
Name:SHAH, SYED G (MD)
Entity Type:Individual
Prefix:
First Name:SYED
Middle Name:G
Last Name:SHAH
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1230 S CEDAR CREST BLVD
Mailing Address - Street 2:SUITE 301
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18103-6367
Mailing Address - Country:US
Mailing Address - Phone:610-432-4529
Mailing Address - Fax:610-432-2206
Practice Address - Street 1:693 PORT CARBON SAINT CLAIR HWY
Practice Address - Street 2:
Practice Address - City:POTTSVILLE
Practice Address - State:PA
Practice Address - Zip Code:17901-8604
Practice Address - Country:US
Practice Address - Phone:570-429-1432
Practice Address - Fax:570-429-1019
Is Sole Proprietor?:No
Enumeration Date:2006-02-08
Last Update Date:2017-03-08
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Provider Licenses
StateLicense IDTaxonomies
PAMD021858E207R00000X, 207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0000099134OtherBLUE SHIELD
PA020301000OtherFEDERAL BLACK LUNG
PA19855OtherGEISINGER HEALTH PLAN
PA0006506130001Medicaid
PA0473231OtherUS HEALTHCARE
PA116993900OtherFEDERAL EMPLOYEES COMP
PA50047349OtherCAPITAL BLUE CROSS
PA01162201OtherKEYSTONE
PA0998130OtherKEYSTONE SPECIALIST
PA110031030OtherRAILROAD MEDICARE PBA
PA50047349OtherCAPITAL BLUE CROSS
PA110031030OtherRAILROAD MEDICARE PBA