Tariq Shivji, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MT209545 Issued in PA

Practice address

10 Shurs LN
Suite 206
Philadelphia, PA 19127-2123

Phone

(215) 967-1632

NPI assigned

Jun 19, 2015

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1434672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1434672000000",
    "number": "1386026896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 FRANKLIN TOWN BLVD",
            "address_2": "APARTMENT 305",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191031240",
            "telephone_number": "347-681-6734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 SHURS LN",
            "address_2": "SUITE 206",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191272123",
            "telephone_number": "215-967-1632"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIVJI",
        "first_name": "TARIQ",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-19",
        "last_updated": "2015-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MT209545",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shiva Om LLC
• Poojita Shivamurthy, MD
• Raina Shivashankar, MD
• Matthew Shive, LPC
• Susan Shively, M.D.
• Richard David Shlansky-Goldberg, MD
• Anatoly Shlobin, PT
• Erica L Shmilovich, LPC
• Amber I Shmuckler, MFT
• Shanny Shmuel, PSYD

• Family Medicine Physician in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Family Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.