Provider Demographics
NPI:1356339972
Name:SHAFI, ARIF (MD)
Entity type:Individual
Prefix:
First Name:ARIF
Middle Name:
Last Name:SHAFI
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 1:6918 SHALLOWFORD RD
Mailing Address - Street 2:SUITE 206
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37421-6784
Mailing Address - Country:US
Mailing Address - Phone:423-855-2552
Mailing Address - Fax:423-855-9041
Practice Address - Street 1:409 DODDS AVE
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37404-3908
Practice Address - Country:US
Practice Address - Phone:423-624-4024
Practice Address - Fax:423-624-7048
Is Sole Proprietor?:No
Enumeration Date:2005-10-07
Last Update Date:2024-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN026768208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3096189Medicaid
GA000677278AMedicaid
TNQ004898Medicaid
G16561Medicare UPIN
TN103I371908Medicare PIN
GA000677278AMedicaid
TN3096189Medicare PIN