Basic Information
| Provider Information | |||||||||
| NPI: | 1316243207 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MERCHANT | ||||||||
| FirstName: | SHAHINA | ||||||||
| MiddleName: | RAHIM | ||||||||
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| Credential: | MHS, PA -C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3421 CONCORD RD | ||||||||
| Address2: | |||||||||
| City: | YORK | ||||||||
| State: | PA | ||||||||
| PostalCode: | 174029001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7177214740 | ||||||||
| FaxNumber: | 7177386872 | ||||||||
| Practice Location | |||||||||
| Address1: | 169 MARTIN AVE | ||||||||
| Address2: | |||||||||
| City: | EPHRATA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 175221724 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7177214740 | ||||||||
| FaxNumber: | 7177386872 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/10/2011 | ||||||||
| LastUpdateDate: | 04/05/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 04/05/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363A00000X | MA054829 | PA | N | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | 363AM0700X | MA054829 | PA | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Medical |
ID Information
| ID | Type | State | Issuer | Description | P01372052 | 01 | PA | RAILROAD MEDICARE | OTHER | 2686821 | 01 | PA | HIGHMARK BLUE SHIELD - FREEDOM BLUE | OTHER | 1604869 | 01 | PA | GATEWAY MEDICARE ASSURED | OTHER | 1604869 | 01 | PA | GATEWAY HEALTH PLAN | OTHER |