Individual
KHALED SHAFIEI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3510 MEDICAL PARK DR., SUITE 9, MONROE, LA 71203
(318) 388-6050
(318) 998-3022
Mailing address
3510 MEDICAL PARK DR., SUITE 9, MONROE, LA 71203
(318) 388-6050
(318) 998-3022
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
026713
LA
207Q00000X
Family Medicine Physician
Primary
026713
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1423521
—
LA
Enumeration date
06/24/2006
Last updated
09/30/2011
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