Individual
DR. SHAHID MUFTI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
520 MARY ST, SUITE 230, EVANSVILLE, IN 47710
(812) 464-9133
(812) 464-0559
Mailing address
PO BOX 1230, EVANSVILLE, IN 47706-1230
(812) 450-7899
(812) 450-6029
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
01035053A
IN
207RC0000X
Cardiovascular Disease Physician
Primary
01035053A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000606368
ANTHEM
IN
05
—
036061926
—
IL
05
—
100101370A
—
IN
05
—
64872385
—
KY
Enumeration date
07/08/2005
Last updated
08/13/2018
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