Dr Shahla Amjad Kaukab, MD is a
Pediatrics physician based in Soddy Daisy, Tennessee. Dr Shahla Amjad Kaukab is licensed to practice in Tennessee (license number 37633) and her current practice location is 9089 Dayton Pike, Soddy Daisy, Tennessee. She can be reached at her office (for appointments etc.) via phone at
(423) 451-0623.
NPI number for Dr Shahla Amjad Kaukab is 1699703264 and her current mailing address is Po Box 1059, Soddy Daisy, Tennessee. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1699703264.
Physician's Profile
| Full Name | Dr Shahla Amjad Kaukab |
|---|
| Gender | Female |
|---|
| Speciality | Pediatrics |
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| Location | 9089 Dayton Pike, Soddy Daisy, Tennessee |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1699703264
- Provider Enumeration Date: 06/30/2006
- Last Update Date: 04/17/2014
Medical Identifiers
Medical identifiers for Dr Shahla Amjad Kaukab such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1699703264 | NPI | - | NPPES |
| 3887638 | Medicaid | TN | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 208000000X | Pediatrics | 37633 (Tennessee) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Shahla Amjad Kaukab is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Dr Shahla Amjad Kaukab, MD
Po Box 1059,
Soddy Daisy, TN 37384
Ph: (423) 451-0623 | Dr Shahla Amjad Kaukab, MD
9089 Dayton Pike,
Soddy Daisy, TN 37379
Ph: (423) 451-0623 |
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