Shahbodaghi, Siavash David
Shahbodaghi, Siavash David is an individual health care provider with primary practice located at 300 East Hospital Road Dwight David Eisenhower Army Medical Center, Fort Gordon GA 30905-5650. He recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Family Medicine is his primary health care specialty. Shahbodaghi, Siavash David can be contacted via phone (706) 787-9281.Contact Information
Primary practice address
300 East Hospital Road Dwight David Eisenhower Army Medical Center
Fort Gordon GA 30905-5650
Phone: (706) 787-9281
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Student, Health Care / Student in an Organized Health Care Education/Training Program | 390200000X | ||
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 27258 | West Virginia |
Profile Details
| NPI number | 1174904981 |
|---|---|
| LBN Legal business name | Shahbodaghi, Siavash David |
| Credentials | MD/MPH |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 17th, 2015 |
| Last updated | Oct 12th, 2016 - about 8 years ago |
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.
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