MEDICARE: SHAHRIAR ANOUSHFAR D.O.

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	208600000X	Surgery Physician	DO2779	ME
2	208600000X	Surgery Physician	11022	MT

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	000092736	OTHER		BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1841258365
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHAHRIAR ANOUSHFAR D.O.

Provider Business Mailing Address
First Line	:	20 HARTFORD ST
Second Line	:
City	:	HOULTON
State	:	ME
Zip	:	04730-1859
Country	:	US
Telephone Number	:	207-532-2900
Fax Number	:	207-532-5963

Provider Business Practice Location Address
First Line	:	20 HARTFORD ST
Second Line	:
City	:	HOULTON
State	:	ME
Zip	:	04730-1859
Country	:	US
Telephone Number	:	207-532-2900
Fax Number	:	207-532-5963

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

Provider Enumeration Date	:	05/03/2006
Last Update Date	:	04/09/2026

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