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General NPI Number Information
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NPI Number | 1851331862
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Entity Type | Individual
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Provider Name | AHMAD I SHAFI M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/07/2006
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Last Update Date | 01/04/2018
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Provider Practice Location Address
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Address Line | 2960 TONGASS AVE
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City | KETCHIKAN
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State | AK
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Zip | 99901-5742
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Country | US
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Telephone | 907-228-4900
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Fax | 800-852-3264
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Provider Business Mailing Address
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Address Line | 2960 TONGASS AVE
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City | KETCHIKAN
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State | AK
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Zip | 99901-5742
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Country | US
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Telephone | 907-228-4900
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Fax | 800-852-3264
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 35087542
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | MD12277
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License Number State | HI
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