Provider Demographics
NPI:1871552356
Name:ARZU, MD SHAHED (MD)
Entity type:Individual
Prefix:
First Name:MD
Middle Name:SHAHED
Last Name:ARZU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:6224 C DURHAM DR
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33467-8715
Mailing Address - Country:US
Mailing Address - Phone:954-495-6408
Mailing Address - Fax:954-769-0657
Practice Address - Street 1:6224 C DURHAM DR
Practice Address - Street 2:
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33467-8715
Practice Address - Country:US
Practice Address - Phone:954-495-6408
Practice Address - Fax:954-769-0657
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-22
Last Update Date:2015-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY236528208M00000X
NY236538207Q00000X
FLME 92910207Q00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03248097Medicaid
NYJ400027432Medicare PIN