Provider Demographics
NPI:1689655367
Name:SHAFI, MANZAR J (MD)
Entity Type:Individual
Prefix:DR
First Name:MANZAR
Middle Name:J
Last Name:SHAFI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:368 MILL ST
Mailing Address - Street 2:
Mailing Address - City:HAGERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21740-6138
Mailing Address - Country:US
Mailing Address - Phone:301-739-4510
Mailing Address - Fax:301-739-0140
Practice Address - Street 1:368 MILL ST
Practice Address - Street 2:
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21740-6138
Practice Address - Country:US
Practice Address - Phone:301-739-4510
Practice Address - Fax:301-739-0140
Is Sole Proprietor?:No
Enumeration Date:2005-11-09
Last Update Date:2007-11-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD28365207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDD74701Medicare UPIN
MD460MMedicare ID - Type Unspecified