MEDICARE: SHAFI MEDICAL CENTER SC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	207SG0201X	Clinical Genetics (M.D.) Physician
2	207V00000X	Obstetrics & Gynecology Physician
3	208000000X	Pediatrics Physician
4	208600000X	Surgery Physician
5	207Q00000X	Family Medicine Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1053408203
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SHAFI MEDICAL CENTER SC

Provider Business Mailing Address
First Line	:	4555 W SCHROEDER DR
Second Line	:	#170
City	:	MILWAUKEE
State	:	WI
Zip	:	53223-1475
Country	:	US
Telephone Number	:	414-365-3210
Fax Number	:	414-365-3225

Provider Business Practice Location Address
First Line	:	1919 W NORTH AVE
Second Line	:	#200
City	:	MILWAUKEE
State	:	WI
Zip	:	53205
Country	:	US
Telephone Number	:	414-387-1000
Fax Number	:	414-287-1010

Authorized Official
Title or Position	:	OWNER/PRESIDENT
Name	:	MOHAMMAD SHAFI
Credential	:	MD
Telephone Number	:	414-287-1000

Provider Enumeration Date	:	10/09/2006
Last Update Date	:	05/22/2012

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Directions to “SHAFI MEDICAL CENTER SC ” Practice Location

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