Provider Demographics
NPI:1982166542
Name:ROB, SHABNAZ (DO)
Entity type:Individual
Prefix:DR
First Name:SHABNAZ
Middle Name:
Last Name:ROB
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 RUTHERFORD RD STE 101
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17109-4540
Mailing Address - Country:US
Mailing Address - Phone:717-545-5256
Mailing Address - Fax:
Practice Address - Street 1:1 RUTHERFORD RD STE 101
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17109-4540
Practice Address - Country:US
Practice Address - Phone:717-545-5256
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-03
Last Update Date:2024-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS022629207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology