Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Dr. Shahram Jay Mirmanesh, MD, MBA

Individual provider Pediatrics Physician · NPI 1750335360

Dr. Shahram Jay Mirmanesh, MD, MBA is a Pediatric Medicine in Marlton, New Jersey. Qualified in 1983, 43 years ago. Accepts Medicare assignment. Licensed in New Jersey.

Years since qualifying
43
Licensed in
NJ
In the registry since
2006
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.
MBA — Master of Business Administration
A graduate business degree.

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Practice location Address checks out

12000 Lincoln Dr W Ste 311
Marlton, NJ 08053-3402
Phone: (856) 985-8100
Fax: (856) 985-8374
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatrics Physician (primary) Taxonomy 208000000X · Licence 25MA05186900 (NJ)

Record details

NPI number1750335360
Entity typeIndividual (Type 1)
GenderMale
Credentials MD , MBA
Sole proprietorNo
NPI enumeratedMay 19, 2006
Last updated in NPPESJuly 8, 2007

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPEDIATRIC MEDICINE
Also practisesFAMILY PRACTICE
Medical schoolOTHER
Graduated 1983 (43 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations7 on file with Medicare

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