Provider Demographics
NPI:1659344273
Name:SHAH, SHEFALI (MD)
Entity Type:Individual
Prefix:
First Name:SHEFALI
Middle Name:
Last Name:SHAH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:306 N 7TH ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:PA
Mailing Address - Zip Code:17512-2137
Mailing Address - Country:US
Mailing Address - Phone:717-684-9106
Mailing Address - Fax:
Practice Address - Street 1:306 N 7TH ST
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:PA
Practice Address - Zip Code:17512-2137
Practice Address - Country:US
Practice Address - Phone:717-684-9106
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-13
Last Update Date:2010-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD06572L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA080175948OtherRR MEDICARE
PA3968032OtherAETNA-HMO
PA20040361OtherMERCY
PA729782000OtherINDEPENDENCE BLUE CROSS
PAP006097OtherGATEWAY
PAPCP-000000128588OtherUNISON
PA5015114OtherAETNA-NON HMO
PA001703480Medicaid
PA9376951OtherCIGNA
PA000977113OtherHIGHMARK
PA50055886OtherCAPITAL BLUE CROSS & KEYSTONE HEALTH PLAN CENTRAL
PA50055886OtherCAPITAL BLUE CROSS & KEYSTONE HEALTH PLAN CENTRAL