Basic Information
| Provider Information | |||||||||
| NPI: | 1720077381 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BABAR | ||||||||
| FirstName: | SHAHID | ||||||||
| MiddleName: | I | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | |||||||||
| OtherFirstName: | |||||||||
| OtherMiddleName: | |||||||||
| OtherNamePrefix: | |||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | |||||||||
| OtherLastNameType: | |||||||||
| Mailing Information | |||||||||
| Address1: | 555 NORTH DUKE STREET | ||||||||
| Address2: | |||||||||
| City: | LANCASTER | ||||||||
| State: | PA | ||||||||
| PostalCode: | 176043555 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7175448144 | ||||||||
| FaxNumber: | 7175448140 | ||||||||
| Practice Location | |||||||||
| Address1: | 555 NORTH DUKE STREET | ||||||||
| Address2: | |||||||||
| City: | LANCASTER | ||||||||
| State: | PA | ||||||||
| PostalCode: | 176043555 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7175448144 | ||||||||
| FaxNumber: | 7175448140 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/17/2005 | ||||||||
| LastUpdateDate: | 08/15/2012 | ||||||||
| NPIDeactivationReasonCode: | |||||||||
| NPIDeactivationDate: | |||||||||
| NPIReactivationDate: | |||||||||
| ProviderGenderCode: | M | ||||||||
| AuthorizedOfficialLastName: | |||||||||
| AuthorizedOfficialFirstName: | |||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | |||||||||
| AuthorizedOfficialTelephone: | |||||||||
| IsSoleProprietor: | N | ||||||||
| IsOrganizationSubpart: | |||||||||
| ParentOrganizationLBN: | |||||||||
| AuthorizedOfficialNamePrefix: | |||||||||
| AuthorizedOfficialNameSuffix: | |||||||||
| AuthorizedOfficialCredential: | |||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | MD423636 | PA | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207RG0300X | MD423636 | PA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Geriatric Medicine |
ID Information
| ID | Type | State | Issuer | Description | 1010234140002 | 05 | PA | MEDICAID | 1113758 | 01 | PA | AETNA HMO | OTHER | 100431 S1QA | 01 | PA | GEISINGER HEALTH PLAN | OTHER | 1619042 | 01 | PA | HIGHMARK BLUE SHIELD | OTHER | I10180 | 01 | PA | HEALTH ASSURANCE | OTHER | 7183661 | 01 | PA | AETNA NON-HMO | OTHER | 50042428 | 01 | PA | CAPITAL BLUE CROSS | OTHER | P00224717 | 01 | PA | RAILROAD MEDICARE | OTHER | P006153 | 01 | PA | GATEWAY HEALTH PLAN | OTHER |