Provider Demographics
NPI:1588614606
Name:SHAFINIA, SOHRAB (DO)
Entity Type:Individual
Prefix:DR
First Name:SOHRAB
Middle Name:
Last Name:SHAFINIA
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7655 HIGHLAND RD STE 202
Mailing Address - Street 2:
Mailing Address - City:WATERFORD
Mailing Address - State:MI
Mailing Address - Zip Code:48327-1485
Mailing Address - Country:US
Mailing Address - Phone:248-225-4244
Mailing Address - Fax:888-704-0304
Practice Address - Street 1:30275 W 13 MILE RD
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48334-5602
Practice Address - Country:US
Practice Address - Phone:248-225-4244
Practice Address - Fax:888-704-0304
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-11
Last Update Date:2009-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MISS012201207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine