Individual
SHAYA MOKFI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
15011 DAY RD, MISHAWAKA, IN 46545-4328
(574) 855-4310
(574) 855-4313
Mailing address
14533 SEDGWICK CT, GRANGER, IN 46530-4870
(574) 855-4310
(574) 855-4313
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
01046740
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000215942
BCBS
IN
01
—
000000756923
BCBS HOSPITALIST
IN
01
—
021236800
FEDERAL BLACK LUNG
IN
05
—
200171410A
—
IN
Enumeration date
05/24/2006
Last updated
01/05/2023
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