Provider Demographics
NPI:1306132477
Name:SAMADI, SHAHED (MD, MPH)
Entity type:Individual
Prefix:DR
First Name:SHAHED
Middle Name:
Last Name:SAMADI
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:4001 E SUNRISE DR
Mailing Address - Street 2:STE. 120
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85718-4333
Mailing Address - Country:US
Mailing Address - Phone:250-209-7000
Mailing Address - Fax:877-674-4883
Practice Address - Street 1:4001 E SUNRISE DR
Practice Address - Street 2:STE. 120
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85718-4333
Practice Address - Country:US
Practice Address - Phone:250-209-7000
Practice Address - Fax:877-674-4883
Is Sole Proprietor?:No
Enumeration Date:2011-06-27
Last Update Date:2017-04-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ49523207Q00000X
CAA132045207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine