Provider Demographics
NPI:1720077381
Name:BABAR, SHAHID I (MD)
Entity Type:Individual
Prefix:
First Name:SHAHID
Middle Name:I
Last Name:BABAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:555 NORTH DUKE STREET
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17604-3555
Mailing Address - Country:US
Mailing Address - Phone:717-544-8144
Mailing Address - Fax:717-544-8140
Practice Address - Street 1:555 NORTH DUKE STREET
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17604-3555
Practice Address - Country:US
Practice Address - Phone:717-544-8144
Practice Address - Fax:717-544-8140
Is Sole Proprietor?:No
Enumeration Date:2005-10-17
Last Update Date:2012-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD423636207R00000X, 207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1010234140002Medicaid
PA1113758OtherAETNA HMO
PA100431 S1QAOtherGEISINGER HEALTH PLAN
PA1619042OtherHIGHMARK BLUE SHIELD
PAI10180OtherHEALTH ASSURANCE
PA7183661OtherAETNA NON-HMO
PA50042428OtherCAPITAL BLUE CROSS
PAP00224717OtherRAILROAD MEDICARE
PAP006153OtherGATEWAY HEALTH PLAN
PA1010234140002Medicaid
PAP006153OtherGATEWAY HEALTH PLAN