Healthcare Provider Details

I. General information

NPI: 1841236049
Provider Name (Legal Business Name): MAJID SHAFIEI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/22/2006
Last Update Date: 07/08/2020
Certification Date: 07/08/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8675 VALLEY CREEK RD
WOODBURY MN
55125-2337
US

IV. Provider business mailing address

2925 CHICAGO AVE
MINNEAPOLIS MN
55407-1321
US

V. Phone/Fax

Practice location:
  • Phone: 651-241-3000
  • Fax: 651-241-3500
Mailing address:
  • Phone: 612-262-1166
  • Fax: 612-262-4258

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number24445
License Number StateWV
# 2
Primary TaxonomyN
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number24445
License Number StateWV
# 3
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number107241
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: