MEDICARE: KAMRAN SAFDAR M.D.

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RG0100X	Gastroenterology Physician	Q2703	TX
2	207RT0003X	Transplant Hepatology Physician	Q2703	TX
3	207R00000X	Internal Medicine Physician	Q2703	TX

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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1538239439
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAMRAN SAFDAR M.D.

Provider Business Mailing Address
First Line	:	PO BOX 636256
Second Line	:	CENTRAL CREDENTIALING
City	:	CINCINNATI
State	:	OH
Zip	:	45263-6256
Country	:	US
Telephone Number	:	513-585-5507
Fax Number	:	513-585-5511

Provider Business Practice Location Address
First Line	:	8201 EWING HALSALL DRIVE
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78229-4231
Country	:	US
Telephone Number	:	210-575-8425
Fax Number	:	210-575-8480

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/08/2006
Last Update Date	:	05/23/2024

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