Provider Demographics
NPI:1538164140
Name:ARFEEN, SHAHABUL (MD)
Entity type:Individual
Prefix:
First Name:SHAHABUL
Middle Name:
Last Name:ARFEEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 MACARTHUR BLVD
Mailing Address - Street 2:SUITE 400A
Mailing Address - City:MUNSTER
Mailing Address - State:IN
Mailing Address - Zip Code:46321-2915
Mailing Address - Country:US
Mailing Address - Phone:219-931-5227
Mailing Address - Fax:219-932-8455
Practice Address - Street 1:9836 W 400 N
Practice Address - Street 2:STE B
Practice Address - City:MICHIGAN CITY
Practice Address - State:IN
Practice Address - Zip Code:46360-2910
Practice Address - Country:US
Practice Address - Phone:219-878-9531
Practice Address - Fax:219-878-0261
Is Sole Proprietor?:No
Enumeration Date:2005-06-20
Last Update Date:2014-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01043606A207RN0300X
IN01043606207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200040950Medicaid
INF26924Medicare UPIN
IN200040950Medicaid
IN703060GMedicare PIN
IN703060GMedicare PIN