Provider Demographics
NPI:1518054519
Name:SHANAVAS, ZAIFI (MD)
Entity Type:Individual
Prefix:DR
First Name:ZAIFI
Middle Name:
Last Name:SHANAVAS
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 1:10801 LOCKWOOD DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20901-1556
Mailing Address - Country:US
Mailing Address - Phone:301-593-2002
Mailing Address - Fax:301-593-4781
Practice Address - Street 1:10801 LOCKWOOD DR
Practice Address - Street 2:SUITE 200
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20901-1556
Practice Address - Country:US
Practice Address - Phone:301-593-2002
Practice Address - Fax:301-593-4781
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2013-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD59775207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD402520200Medicaid
MDH87113Medicare UPIN
DC012045G74Medicare PIN