Individual
KAMRAN K SHOKOOHI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD PHD
Contact information
Practice address
2393 SCHUST RD, SAGINAW, MI 48603-1334
(989) 793-2820
(989) 793-9132
Mailing address
2393 SCHUST RD, SAGINAW, MI 48603-1334
(989) 793-2820
(989) 793-9132
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
4301067707
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0G36036
MEDICARE
—
01
—
1427090976
GROUP NPI
MI
01
—
180G300890
BLUE CROSS BLUE SHIELD
MI
01
—
180G300890
BLUE CARE NETWORK
—
05
—
4182000
—
MI
05
—
4187472
—
MI
01
—
43010067707
LICENSE
MI
01
—
CA3610
RAILROAD MEDICARE
—
Enumeration date
08/30/2005
Last updated
09/18/2023
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