Provider Demographics
NPI:1518035773
Name:SHAHZAD, FARNAZ A (MD)
Entity type:Individual
Prefix:
First Name:FARNAZ
Middle Name:A
Last Name:SHAHZAD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4735 OGLETOWN STANTON ROAD
Mailing Address - Street 2:MAP II, SUITE 1250
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19713-2076
Mailing Address - Country:US
Mailing Address - Phone:856-691-3300
Mailing Address - Fax:856-794-7183
Practice Address - Street 1:4735 OGLETOWN STANTON ROAD
Practice Address - Street 2:MAP II, SUITE 1250
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19713-2076
Practice Address - Country:US
Practice Address - Phone:302-623-0200
Practice Address - Fax:302-623-0117
Is Sole Proprietor?:No
Enumeration Date:2006-12-04
Last Update Date:2017-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC1-0010844207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine