Individual
JAFAR SHABANPOUR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
12500 WILLOWBROOK RD, CUMBERLAND, MD 21502-6393
(240) 964-7000
(240) 964-7000
Mailing address
12500 WILLOWBROOK RD, CUMBERLAND, MD 21502-6393
(443) 951-4286
(240) 964-7000
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
D0096029
MD
390200000X
Student in an Organized Health Care Education/Training Program
BP10069379
TX
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
08/06/2019
Last updated
08/20/2023
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