Provider Demographics
NPI:1578541488
Name:SHAFIQUE, SHEIKH IRFAN (MD)
Entity Type:Individual
Prefix:DR
First Name:SHEIKH
Middle Name:IRFAN
Last Name:SHAFIQUE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:20 EXPEDITION TRAIL
Mailing Address - Street 2:SUITE 102
Mailing Address - City:GETTYSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17325-8599
Mailing Address - Country:US
Mailing Address - Phone:717-334-4033
Mailing Address - Fax:717-334-5599
Practice Address - Street 1:1030 N CHARLES STREET
Practice Address - Street 2:SUITE 100
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21201-5402
Practice Address - Country:US
Practice Address - Phone:410-605-9393
Practice Address - Fax:410-605-9397
Is Sole Proprietor?:No
Enumeration Date:2006-01-03
Last Update Date:2019-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0040314207U00000X, 2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No207U00000XAllopathic & Osteopathic PhysiciansNuclear Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD073891300Medicaid
DC2849OtherB/C B/S
MDJ062OtherB/C B/S
MDKA80OtherB/C B/S
MDJ062OtherB/C B/S
MDE99592Medicare UPIN
MDCD4495Medicare ID - Type UnspecifiedRAILROAD MEDICARE
MD435LF716Medicare Oscar/Certification
MD073891300Medicaid
DC2849OtherB/C B/S