Basic Information
| Provider Information | |||||||||
| NPI: | 1649214529 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SHAHLAEE | ||||||||
| FirstName: | AMIR | ||||||||
| MiddleName: | H | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 11002 VEIRS MILL ROAD, SUITE 414 | ||||||||
| Address2: | INSTITUTE FOR ASTHMA AND ALLERGY | ||||||||
| City: | WHEATON | ||||||||
| State: | MD | ||||||||
| PostalCode: | 20902 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3019625800 | ||||||||
| FaxNumber: | 3019629585 | ||||||||
| Practice Location | |||||||||
| Address1: | 11002 VEIRS MILL ROAD, SUITE 414 | ||||||||
| Address2: | INSTITUTE FOR ASTHMA AND ALLERGY | ||||||||
| City: | WHEATON | ||||||||
| State: | MD | ||||||||
| PostalCode: | 20902 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3019625800 | ||||||||
| FaxNumber: | 3019629585 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/15/2006 | ||||||||
| LastUpdateDate: | 07/14/2015 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207K00000X | D0057508 | MD | Y | Allopathic & Osteopathic Physicians | Allergy & Immunology | 2080P0207X | ME92043 | FL | N | Allopathic & Osteopathic Physicians | Pediatrics | Pediatric Hematology-Oncology | 2080P0207X | D57508 | MD | N | Allopathic & Osteopathic Physicians | Pediatrics | Pediatric Hematology-Oncology |
ID Information
| ID | Type | State | Issuer | Description | 271425600 | 05 | FL | MEDICAID | 027555700 | 05 | MD | MEDICAID |