Provider Demographics
NPI:1639329543
Name:MUHAMMAD SHAFIQUE MD PC
Entity Type:Organization
Organization Name:MUHAMMAD SHAFIQUE MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MUHAMMAD
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAFIQUE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:702-228-7812
Mailing Address - Street 1:10620 SOUTHERN HIGHLANDS PKWY
Mailing Address - Street 2:SUITE 110-410
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89141-4371
Mailing Address - Country:US
Mailing Address - Phone:702-210-5275
Mailing Address - Fax:
Practice Address - Street 1:10620 SOUTHERN HIGHLANDS PKWY
Practice Address - Street 2:SUITE 110-410
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89141-4371
Practice Address - Country:US
Practice Address - Phone:702-210-5275
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-27
Last Update Date:2010-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV10299207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVBY626AMedicare PIN
BY641ZMedicare PIN
NVH55506Medicare UPIN