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Organization
LAFAYETTE VEIN AND VASCULAR CENTER LLC
Active
Organization
LAFAYETTE VEIN AND VASCULAR CENTER LLC
Active
Other names
Lafayette Vein and Vascular
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHOAIB SHAFIQUE MD (CEO)
(317) 938-3989
Entity
Organization
Contact information
Practice address
3900 ST FRANCIS WAY STE 201, LAFAYETTE, IN 47905-4925
(765) 404-1454
Mailing address
2809 IBIS CT, WEST LAFAYETTE, IN 47906-6625
(765) 404-1454
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
—
NULL
2086S0129X
Vascular Surgery Physician
Primary
—
—
Other
Enumeration date
02/20/2023
Last updated
02/20/2023
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