Provider Demographics
NPI:1750345617
Name:SHAFQAT, SYED IMRAN (MD)
Entity type:Individual
Prefix:
First Name:SYED
Middle Name:IMRAN
Last Name:SHAFQAT
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 1:4057 QUARLES CT
Mailing Address - Street 2:
Mailing Address - City:HARRISONBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22801-8717
Mailing Address - Country:US
Mailing Address - Phone:540-574-2920
Mailing Address - Fax:540-564-0880
Practice Address - Street 1:4057 QUARLES CT
Practice Address - Street 2:
Practice Address - City:HARRISONBURG
Practice Address - State:VA
Practice Address - Zip Code:22801-8717
Practice Address - Country:US
Practice Address - Phone:540-574-2920
Practice Address - Fax:540-564-0880
Is Sole Proprietor?:No
Enumeration Date:2006-04-16
Last Update Date:2023-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101230544207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA5858453Medicaid
G61888Medicare UPIN