Individual
DR. KIUMARS E. SHAMS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5389 COTTON ST, GRACEVILLE, FL 32440-1739
(850) 360-4147
(850) 360-4068
Mailing address
PO BOX 186, GRACEVILLE, FL 32440-0186
(850) 360-4147
(850) 360-4068
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
ME29949
FL
2084P0800X
Psychiatry Physician
Primary
ME29949
FL
2084P2900X
Pain Medicine (Psychiatry & Neurology) Physician
ME29949
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
038295700
—
FL
01
—
582678372
TRICARE
FL
01
—
79178
BCBS FL
FL
Enumeration date
01/29/2007
Last updated
12/16/2025
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