Individual
DAVID C SHAHBAZI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1414 W FAIR AVE, STE 36, MARQUETTE, MI 49855-2675
(906) 225-3864
(906) 225-3851
Mailing address
330 SEVEN SPRINGS WAY, BRENTWOOD, TN 37027-5098
(615) 920-7000
(615) 920-8775
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
4301053462
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080036038
RAILROAD MEDICARE
MI
05
—
2853464
—
MI
Enumeration date
11/01/2005
Last updated
06/06/2019
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