Provider Demographics
NPI:1073687000
Name:SHAFIK, AHMED SATEH (MD)
Entity Type:Individual
Prefix:
First Name:AHMED
Middle Name:SATEH
Last Name:SHAFIK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6569 N CHARLES STREET
Mailing Address - Street 2:SUITE 405
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21204
Mailing Address - Country:US
Mailing Address - Phone:410-339-7757
Mailing Address - Fax:410-339-7875
Practice Address - Street 1:6569 N CHARLES STREET
Practice Address - Street 2:SUITE 405
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204
Practice Address - Country:US
Practice Address - Phone:410-339-7757
Practice Address - Fax:410-339-7875
Is Sole Proprietor?:No
Enumeration Date:2006-11-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD17944208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
D74440Medicare UPIN
MD7641Medicare ID - Type Unspecified