Shafa, Morteza
Shafa, Morteza is an sole proprietor health care provider with primary practice located at 245 Broadway St. , La Center KY 42056. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Shafa, Morteza can be contacted via phone (270) 665-9195.Contact Information
Primary practice address
245 Broadway St.
La Center KY 42056
Phone: (270) 665-9195
Fax: (270) 665-5420
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 22367 | Kentucky |
Profile Details
| NPI number | 1669407458 |
|---|---|
| LBN Legal business name | Shafa, Morteza |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jul 11th, 2006 |
| Last updated | Jul 8th, 2007 - about 19 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1669407458 | NPPES |
| Kentucky | MEDICAID | 64223670 |
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