Healthcare Provider Details

I. General information

NPI: 1093927642
Provider Name (Legal Business Name): SHABBIR ALI NAQVI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2007
Last Update Date: 09/27/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5936 LIMESTONE RD STE 301
HOCKESSIN DE
19707-8932
US

IV. Provider business mailing address

108 SOMERSET RD
WILMINGTON DE
19808-4406
US

V. Phone/Fax

Practice location:
  • Phone: 302-234-2380
  • Fax:
Mailing address:
  • Phone: 732-890-1121
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085B0100X
TaxonomyBody Imaging Physician
License NumberC1-0009692
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: