Individual
DR. MORTEZA SHAHMIR
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1211 WOODHURST ST, BOWLING GREEN, KY 42104-3368
(270) 782-7373
(270) 796-8676
Mailing address
1211 WOODHURST ST, BOWLING GREEN, KY 42104-3368
(270) 782-7373
(270) 796-8676
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
20065
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1389436
ECFMG
—
05
—
64200652
—
KY
Enumeration date
05/24/2005
Last updated
07/08/2007
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