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MR. SHAHROOZ SAHEB JAMIE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
43 MAIN ST, CLAY, WV 25043
(304) 587-2636
(304) 587-4789
Mailing address
43 MAIN ST, PO BOX 10, CLAY, WV 25043
(304) 587-2636
(304) 587-4789

Taxonomy

Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
10485
WV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0055781000
WV
01
0699802
FUNDS
WA
Enumeration date
06/22/2006
Last updated
07/08/2007
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