Healthcare Provider Details

I. General information

NPI: 1043862451
Provider Name (Legal Business Name): AHMED ELSHAFIE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/15/2019
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

788 SERVICE RD RM B301788
EAST LANSING MI
48824-7013
US

IV. Provider business mailing address

161 FORT WASHINGTON AVE
NEW YORK NY
10032-3729
US

V. Phone/Fax

Practice location:
  • Phone: 517-432-2404
  • Fax:
Mailing address:
  • Phone: 212-342-0444
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number342353
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number4351044120
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: