Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0300X | Geriatric Medicine | MD443337 | PA |
NPI | 1164660866 |
---|---|
Provider Name | Shadab Kalim |
First Address | Sharon, PA 16146-1503 |
Second Address | Altoona, PA 16601-3100 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/02/2009 |
Last Update Date | 15/06/2021 |