Individual
DR. ANOUSHEH SHAFA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
6500 EXCELSIOR BLVD, ST LOUIS PARK, MN 55426-4702
(952) 993-3282
Mailing address
8170 33RD AVE S # MS 21110Q, BLOOMINGTON, MN 55425-4516
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
28768
MN
207V00000X
Obstetrics & Gynecology Physician
Primary
64362
MN
207VX0201X
Gynecologic Oncology Physician
64362
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1225563836
OTHER
MN
Enumeration date
04/21/2017
Last updated
10/03/2024
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