Individual
KHURRAM SHAFIQUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5225 23RD AVE S, FARGO, ND 58104-7927
(701) 417-2575
Mailing address
450 CLARKSON AVE, BOX 1262, BROOKLYN, NY 11203-2012
(646) 247-2340
Taxonomy
Speciality
Code
Description
License number
State
207ZP0105X
Clinical Pathology/Laboratory Medicine Physician
Primary
15742
ND
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/23/2013
Last updated
12/31/2019
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