Ehtesham, Shahab M

Ehtesham, Shahab M is an sole proprietor health care provider with primary practice located at 611 Trent St Ne , Norton VA 24273-1533. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Ehtesham, Shahab M can be contacted via phone (276) 679-4200.

Contact Information

Primary practice address
611 Trent St Ne Norton VA 24273-1533
Phone: (276) 679-4200
Fax: (276) 679-4230
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 32845 Kentucky
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 0101225223 Virginia

Profile Details

NPI number 1144283029
LBN Legal business name Ehtesham, Shahab M
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 11th, 2006
Last updated Jun 21st, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1144283029 NPPES
Virginia MEDICAID 010287669

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