Provider Demographics
NPI:1134169386
Name:KAMBIN, SHELIA PARVIN (MD)
Entity type:Individual
Prefix:DR
First Name:SHELIA
Middle Name:PARVIN
Last Name:KAMBIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:100 LANCASTER AVE
Mailing Address - Street 2:SUITE 661 LANKENAU MOB EAST
Mailing Address - City:WYNNEWOOD
Mailing Address - State:PA
Mailing Address - Zip Code:19096-3437
Mailing Address - Country:US
Mailing Address - Phone:610-649-8085
Mailing Address - Fax:610-649-8984
Practice Address - Street 1:100 LANCASTER AVE
Practice Address - Street 2:SUITE 661 LANKENAU MOB EAST
Practice Address - City:WYNNEWOOD
Practice Address - State:PA
Practice Address - Zip Code:19096-3437
Practice Address - Country:US
Practice Address - Phone:610-649-8085
Practice Address - Fax:610-649-8984
Is Sole Proprietor?:No
Enumeration Date:2006-06-07
Last Update Date:2012-01-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD424738207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1022647350002Medicaid
PA2409273000OtherINDEPENDENCE BLUE CROSS
PA2409273000OtherINDEPENDENCE BLUE CROSS
PA802046J5PMedicare PIN
PA1022647350002Medicaid