Provider Demographics
NPI:1053458216
Name:NAWAB, STEFAN SHAHRAM (MD)
Entity Type:Individual
Prefix:DR
First Name:STEFAN
Middle Name:SHAHRAM
Last Name:NAWAB
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:650 E INDIAN SCHOOL RD
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85012-1839
Mailing Address - Country:US
Mailing Address - Phone:602-277-5551
Mailing Address - Fax:602-277-2723
Practice Address - Street 1:650 E INDIAN SCHOOL RD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85012-1839
Practice Address - Country:US
Practice Address - Phone:602-277-5551
Practice Address - Fax:602-222-2723
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2022-07-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
KS04-334012084P0800X
AZ416272084P0800X
MO20020137202084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry