Provider Demographics
NPI:1174666044
Name:INSAF, SHAHID S (MD)
Entity Type:Individual
Prefix:DR
First Name:SHAHID
Middle Name:S
Last Name:INSAF
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 1:3142 W. REMINGTON CT
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65810-2580
Mailing Address - Country:US
Mailing Address - Phone:417-243-7777
Mailing Address - Fax:417-243-7778
Practice Address - Street 1:500 W. MAIN STREET
Practice Address - Street 2:SUITE 400
Practice Address - City:BRANSON
Practice Address - State:MO
Practice Address - Zip Code:65616-2201
Practice Address - Country:US
Practice Address - Phone:417-243-7777
Practice Address - Fax:417-243-7778
Is Sole Proprietor?:No
Enumeration Date:2007-02-14
Last Update Date:2009-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20050344722084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO207592304Medicaid
MO203025OtherMO BLUE SHIELD
AR160533001Medicaid
AR83726OtherARK BLUE SHIELD
MO203025OtherMO BLUE SHIELD
AR160533001Medicaid