Ehtesham, Shahab M
Ehtesham, Shahab M is an sole proprietor health care provider with primary practice located at 611 Trent St Ne , Norton VA 24273-1533. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Ehtesham, Shahab M can be contacted via phone (276) 679-4200.Contact Information
Primary practice address
611 Trent St Ne
Norton VA 24273-1533
Phone: (276) 679-4200
Fax: (276) 679-4230
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 32845 | Kentucky |
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 0101225223 | Virginia |
Profile Details
| NPI number | 1144283029 |
|---|---|
| LBN Legal business name | Ehtesham, Shahab M |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Apr 11th, 2006 |
| Last updated | Jun 21st, 2023 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1144283029 | NPPES |
| Virginia | MEDICAID | 010287669 |
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