Provider Demographics
NPI:1649214529
Name:SHAHLAEE, AMIR H (MD)
Entity Type:Individual
Prefix:DR
First Name:AMIR
Middle Name:H
Last Name:SHAHLAEE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:11002 VEIRS MILL ROAD, SUITE 414
Mailing Address - Street 2:INSTITUTE FOR ASTHMA AND ALLERGY
Mailing Address - City:WHEATON
Mailing Address - State:MD
Mailing Address - Zip Code:20902
Mailing Address - Country:US
Mailing Address - Phone:301-962-5800
Mailing Address - Fax:301-962-9585
Practice Address - Street 1:4534A JOHN MARR DR
Practice Address - Street 2:
Practice Address - City:ANNANDALE
Practice Address - State:VA
Practice Address - Zip Code:22003-3308
Practice Address - Country:US
Practice Address - Phone:301-962-5800
Practice Address - Fax:301-962-9585
Is Sole Proprietor?:No
Enumeration Date:2006-06-15
Last Update Date:2023-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD575082080P0207X
FLME920432080P0207X
MDD0057508207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
No2080P0207XAllopathic & Osteopathic PhysiciansPediatricsPediatric Hematology-Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL271425600Medicaid
MD027555700Medicaid
FL52250ZMedicare PIN
MD169911ZAWAMedicare PIN
I25060Medicare UPIN
FL271425600Medicaid