Provider Demographics
NPI:1598938946
Name:SHAHNIA, SHAHIN (MD)
Entity Type:Individual
Prefix:DR
First Name:SHAHIN
Middle Name:
Last Name:SHAHNIA
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 1:2809 E. HAMILTON AVE
Mailing Address - Street 2:SUITE 107
Mailing Address - City:EAU CLAIRE
Mailing Address - State:WI
Mailing Address - Zip Code:54707-2275
Mailing Address - Country:US
Mailing Address - Phone:715-834-1555
Mailing Address - Fax:715-835-0263
Practice Address - Street 1:2809 E HAMILTON AVE
Practice Address - Street 2:SUITE 107
Practice Address - City:EAU CLAIRE
Practice Address - State:WI
Practice Address - Zip Code:54701-6863
Practice Address - Country:US
Practice Address - Phone:715-834-1555
Practice Address - Fax:715-835-0263
Is Sole Proprietor?:No
Enumeration Date:2008-04-07
Last Update Date:2013-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI54997-20207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI61113OtherDEAN HEALTH PLAN