Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0201X | Gynecologic Oncologist | MD073008L | PA |
NPI | 1568440451 |
---|---|
Provider Name | Mark S Shahin |
First Address | Willow Grove, PA 19090-1104 |
Second Address | Willow Grove, PA 19090-1104 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/01/2006 |
Last Update Date | 26/09/2018 |