| Shahab M. Ehtesham Md Pllc | |
|
611 Trent St Ne Norton VA 24273-1533 | |
| (276) 679-4200 | |
| (276) 679-4230 |
| Full Name | Shahab M. Ehtesham Md Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 611 Trent St Ne, Norton, Virginia |
| Authorized Official Name and Position | Shahab M. Ehtesham (PHYSICIAN) |
| Authorized Official Contact | 2766794200 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Shahab M. Ehtesham Md Pllc Po Box 386 Wise VA 24293-0386 Ph: (276) 679-4200 | Shahab M. Ehtesham Md Pllc 611 Trent St Ne Norton VA 24273-1533 Ph: (276) 679-4200 |
| NPI Number | 1184804163 |
|---|---|
| Provider Enumeration Date | 11/07/2007 |
| Last Update Date | 02/01/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184804163 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 0101225223 (Virginia) | Primary |
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