Basic Information
| Provider Information | |||||||||
| NPI: | 1093009839 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SHIF | ||||||||
| FirstName: | OLGA | ||||||||
| MiddleName: | A | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 901 DULANEY VALLEY RD | ||||||||
| Address2: | THE NATIONAL RETINA INSTITUTE | ||||||||
| City: | TOWSON | ||||||||
| State: | MD | ||||||||
| PostalCode: | 212042600 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4103374500 | ||||||||
| FaxNumber: | 4103397326 | ||||||||
| Practice Location | |||||||||
| Address1: | 901 DULANEY VALLEY RD | ||||||||
| Address2: | THE NATIONAL RETINA INSTITUTE | ||||||||
| City: | TOWSON | ||||||||
| State: | MD | ||||||||
| PostalCode: | 212042600 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4103374500 | ||||||||
| FaxNumber: | 4103397326 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/08/2011 | ||||||||
| LastUpdateDate: | 07/08/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207W00000X | D0079322 | MD | Y | Allopathic & Osteopathic Physicians | Ophthalmology | 390200000X | MT199281 | PA | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 390200000X | BP10043955 | TX | N | Student, Health Care | Student in an Organized Health Care Education/Training Program |
No ID Information.