Provider Demographics
NPI:1174581763
Name:RAHIMIAN, SHAHIN MOHAMMAD (DO)
Entity type:Individual
Prefix:DR
First Name:SHAHIN
Middle Name:MOHAMMAD
Last Name:RAHIMIAN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 MEMORY LN
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-2231
Mailing Address - Country:US
Mailing Address - Phone:717-851-1405
Mailing Address - Fax:
Practice Address - Street 1:501 E MAIN ST
Practice Address - Street 2:
Practice Address - City:WAYNESBORO
Practice Address - State:PA
Practice Address - Zip Code:17268-2353
Practice Address - Country:US
Practice Address - Phone:717-765-3648
Practice Address - Fax:717-765-3647
Is Sole Proprietor?:No
Enumeration Date:2006-05-03
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV2108207RG0100X
MDH71639207RG0100X
PAOS011184L207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV001767952OtherBLUE CROSS BLUE SHIELD
WV3810003032Medicaid
I38702Medicare UPIN
WV001767952OtherBLUE CROSS BLUE SHIELD
WVRA4166761Medicare ID - Type Unspecified
MD239130ZABGMedicare PIN