Provider Demographics
NPI:1619943461
Name:SHAW-STIFFEL, THOMAS AW (MD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:AW
Last Name:SHAW-STIFFEL
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 1:3601 5TH AVE
Mailing Address - Street 2:3RD FLOOR FALK CLINIC, CENTER FOR LIVER DISEASE,
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15213-3403
Mailing Address - Country:US
Mailing Address - Phone:412-647-1170
Mailing Address - Fax:
Practice Address - Street 1:3601 5TH AVE
Practice Address - Street 2:3RD FLOOR FALK CLINIC, CENTER FOR LIVER DISEASE,
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15213-3403
Practice Address - Country:US
Practice Address - Phone:412-647-1170
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD420278174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA064158D8RMedicare ID - Type Unspecified
PAE78623Medicare UPIN