Omid Shafaat, MD
Student in an Organized Health Care Education/Training Program in Philadelphia, PA. Individual provider (NPI-1).
Details
- NPI
- 1124778063
- Entity type
- Individual (NPI-1)
- Name
- Omid Shafaat
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Mar 24, 2022
- Certification date
- Mar 28, 2022
- Last updated
- Mar 28, 2022
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 390200000X | Student in an Organized Health Care Education/Training Program | – | – | Yes |
Practice location
3400 Spruce StPhiladelphia, PA 19104-4238
Phone 267-331-0953
Mailing address
3400 Spruce StPhiladelphia, PA 19104-4238
Phone 215-662-6156
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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