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Organization

SHAHAB M. EHTESHAM MD PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. SHAHAB M. EHTESHAM M.D. (PHYSICIAN)
(276) 679-4200
Entity
Organization

Contact information

Practice address
611 TRENT ST NE, NORTON, VA 24273-1533
(276) 679-4200
(276) 679-4230
Mailing address
PO BOX 386, WISE, VA 24293-0386
(276) 679-4200
(276) 679-4230

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0101225223
VA

Other

Enumeration date
11/07/2007
Last updated
02/01/2010
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