Provider Demographics
NPI:1699879056
Name:ARABSHAHI, HAMID REZA (DPM)
Entity type:Individual
Prefix:MR
First Name:HAMID
Middle Name:REZA
Last Name:ARABSHAHI
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1550
Mailing Address - Street 2:
Mailing Address - City:SHERWOOD
Mailing Address - State:OR
Mailing Address - Zip Code:97140-1550
Mailing Address - Country:US
Mailing Address - Phone:503-932-0885
Mailing Address - Fax:503-625-8638
Practice Address - Street 1:1475 COMMERCIAL ST SE
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97302-4307
Practice Address - Country:US
Practice Address - Phone:503-391-0688
Practice Address - Fax:503-625-8638
Is Sole Proprietor?:No
Enumeration Date:2006-09-07
Last Update Date:2023-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORDP00296213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR158911Medicaid
ORCJ6522OtherRAILROAD MEDICARE
OR480034478OtherPALMETTO GBA, RAILROAD ME
ORCK4411OtherRAILROAD MEDICARE
OR480033300OtherPALMETTO GBA, RAILROAD ME
U71028Medicare UPIN
OR158911Medicaid
OR5738490002Medicare NSC