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General NPI Number Information
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NPI Number | 1881183960
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Entity Type | Individual
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Provider Name | MOHAMED AMER SHAFTER
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Gender | Male
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Dates
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Enumeration Date | 05/04/2018
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Last Update Date | 05/04/2018
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Provider Practice Location Address
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Address Line | 875 UNION AVE FL 5
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City | MEMPHIS
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State | TN
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Zip | 38103-3513
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Country | US
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Telephone | 857-236-1574
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Fax |
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Provider Business Mailing Address
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Address Line | 875 UNION AVE FL 5
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City | MEMPHIS
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State | TN
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Zip | 38103-3513
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Country | US
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Telephone | 857-236-1574
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Fax |
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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 | 1223P0700X
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Taxonomy Name | Prosthodontics
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License Number | 3984-18
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License Number State | MS
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