Provider Demographics
NPI:1881906592
Name:SHAH-HAQUE, SAPNA (MD)
Entity type:Individual
Prefix:
First Name:SAPNA
Middle Name:
Last Name:SHAH-HAQUE
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:PO BOX 762
Mailing Address - Street 2:
Mailing Address - City:WINFIELD
Mailing Address - State:KS
Mailing Address - Zip Code:67156-0762
Mailing Address - Country:US
Mailing Address - Phone:620-221-4000
Mailing Address - Fax:
Practice Address - Street 1:1230 E 6TH AVE
Practice Address - Street 2:SUITE 1B
Practice Address - City:WINFIELD
Practice Address - State:KS
Practice Address - Zip Code:67156-3143
Practice Address - Country:US
Practice Address - Phone:620-221-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-10
Last Update Date:2014-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS7551207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine