Provider Demographics
NPI:1447214549
Name:RAFIQ, SHAHID (MD)
Entity Type:Individual
Prefix:DR
First Name:SHAHID
Middle Name:
Last Name:RAFIQ
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 1:196 THOMAS JOHNSON DR
Mailing Address - Street 2:SUITE 120
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21702-4397
Mailing Address - Country:US
Mailing Address - Phone:240-566-3130
Mailing Address - Fax:240-566-3131
Practice Address - Street 1:196 THOMAS JOHNSON DR
Practice Address - Street 2:SUITE 120
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21702-4397
Practice Address - Country:US
Practice Address - Phone:240-566-3130
Practice Address - Fax:240-566-3131
Is Sole Proprietor?:No
Enumeration Date:2006-04-14
Last Update Date:2015-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0064266204D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMM
Provider Identifiers
StateIdentifier IDID TypeIssuer
1345981OtherAETNA PVN
MD410515000Medicaid
4387-0001OtherCAREFIRST BCBS GHMSI
2630838OtherUNITED
880603-01OtherCAREFIRST BCBS MARYLAND
2630838OtherUNITED