Provider Demographics
NPI:1316394158
Name:SHOUKAT, UMER (MD)
Entity type:Individual
Prefix:
First Name:UMER
Middle Name:
Last Name:SHOUKAT
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2608 KEISER BLVD
Mailing Address - Street 2:
Mailing Address - City:WYOMISSING
Mailing Address - State:PA
Mailing Address - Zip Code:19610-3333
Mailing Address - Country:US
Mailing Address - Phone:610-685-5864
Mailing Address - Fax:610-929-1528
Practice Address - Street 1:2608 KEISER BLVD
Practice Address - Street 2:
Practice Address - City:WYOMISSING
Practice Address - State:PA
Practice Address - Zip Code:19610-3333
Practice Address - Country:US
Practice Address - Phone:610-685-5864
Practice Address - Fax:610-929-1528
Is Sole Proprietor?:No
Enumeration Date:2016-05-23
Last Update Date:2025-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT211271207R00000X
PAMD467751207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine