Provider Demographics
NPI:1124430947
Name:MAHGEREFTEH, SHMUEL (MD)
Entity type:Individual
Prefix:DR
First Name:SHMUEL
Middle Name:
Last Name:MAHGEREFTEH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 SPRUCE ST
Mailing Address - Street 2:PENNSYLVANIA HOSPITAL - DEPARTMENT OF RADIOLOGY
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19107-6130
Mailing Address - Country:US
Mailing Address - Phone:215-829-6657
Mailing Address - Fax:215-829-7482
Practice Address - Street 1:800 SPRUCE ST
Practice Address - Street 2:PENNSYLVANIA HOSPITAL - DEPARTMENT OF RADIOLOGY
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19107-6130
Practice Address - Country:US
Practice Address - Phone:215-829-6657
Practice Address - Fax:215-829-7482
Is Sole Proprietor?:No
Enumeration Date:2014-05-28
Last Update Date:2014-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program