Provider Demographics
NPI:1639133952
Name:WEST, SHAWN C (MD)
Entity Type:Individual
Prefix:
First Name:SHAWN
Middle Name:C
Last Name:WEST
Suffix:
Gender:M
Credentials:MD
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Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4401 PENN AVE
Mailing Address - Street 2:FACULTY PAVILION, FLOOR 5
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15224-1334
Mailing Address - Country:US
Mailing Address - Phone:412-692-5624
Mailing Address - Fax:412-692-6991
Practice Address - Street 1:4401 PENN AVE
Practice Address - Street 2:FACULTY PAVILION, FLOOR 5
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15224-1334
Practice Address - Country:US
Practice Address - Phone:412-692-5624
Practice Address - Fax:412-692-6991
Is Sole Proprietor?:No
Enumeration Date:2006-04-13
Last Update Date:2023-01-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA052495174400000X
PAMD4459982080P0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0202XAllopathic & Osteopathic PhysiciansPediatricsPediatric Cardiology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA110196487AMedicaid