Individual
MUBARIK AHMAD SHAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6248 STONE HILL CT, PORT TOBACCO, MD 20677-3403
(267) 909-3310
(301) 934-4678
Mailing address
6248 STONE HILL CT, PORT TOBACCO, MD 20677-3403
(267) 909-3310
(301) 934-4678
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
ME89362
FL
2086S0129X
Vascular Surgery Physician
ME89362
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
270463300
—
FL
01
—
48756
BCBS
FL
Enumeration date
08/24/2005
Last updated
04/08/2014
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