Shams, Mitra
Shams, Mitra is an individual health care provider with primary practice located at 6041 Timber Ridge Dr , Prospect KY 40059-8134. She recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as her primary health care specialty. Shams, Mitra can be contacted via phone (502) 228-2225.Contact Information
Primary practice address
6041 Timber Ridge Dr
Prospect KY 40059-8134
Phone: (502) 228-2225
Fax: (502) 228-2226
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | TP723 | Kentucky |
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 40284 | Kentucky |
Profile Details
| NPI number | 1043310329 |
|---|---|
| LBN Legal business name | Shams, Mitra |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 25th, 2006 |
| Last updated | Nov 29th, 2012 - about 12 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1043310329 | NPPES |
| Kentucky | Other | 000000699132 | ANTHEM - NCMA |
| Kentucky | Other | 50031915 | ANTHEM - NCMA |
| Kentucky | Other | 7659346 | ANTHEM - NCMA |
| Kentucky | Other | P00893048 | ANTHEM - NCMA |
| Kentucky | MEDICAID | 7100020180 | ANTHEM - NCMA |
| Kentucky | MEDICAID | 200859040 | ANTHEM - NCMA |
| Kentucky | Other | 121562 | ANTHEM - NCMA |
| Kentucky | Other | 000057058T | ANTHEM - NCMA |
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