Organization
SHAMSUDDIN KHWAJA M D INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GLORIA SUPERNAW (BILLING CONTRACTING MGR)
(559) 935-5491
Entity
Organization
Contact information
Practice address
729 WEST MEDICAL CENTER DR W SUITE 223, CLOVIS, CA 93611-6885
(559) 449-9990
(559) 449-9991
Mailing address
729 WEST MEDICAL CENTER DR W SUITE 223, CLOVIS, CA 93611-6885
(559) 449-9990
(559) 449-9991
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
A859070
CA
Other
Enumeration date
01/14/2010
Last updated
02/06/2020
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