Individual
DR. SHAHIR OKHOVAT-GHAHFAROKHI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1627 E BRISTOL ST, ELKHART, IN 46514-3817
(574) 262-0313
(574) 389-4879
Mailing address
3245 HEALTH DR STE 100, GRANGER, IN 46530-1380
(574) 647-2129
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
01090394A
IN
208000000X
Pediatrics Physician
036143877
IL
208000000X
Pediatrics Physician
125065102
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300078000
—
IN
Enumeration date
08/05/2014
Last updated
03/11/2024
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