Sean Shahzad Dailami-Pour, MD
Individual provider Active NPI Family Medicine Physician · Belzoni, MS
NPI 1689731606 · NPPES record last updated Jul 18, 2013
Key facts
- NPI
- 1689731606
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 17099 (MS)
- Practice address
- 116 Hayden Street
Belzoni, MS 39038 - Phone
- (662) 247-1252
- Fax
- (662) 247-3865
- NPI assigned
- Jan 2, 2007
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 7
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MS
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20090812000001 | MS | Practitioner - Emergency Medicine | 9638223530 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 17099 | MS | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pontotoc Health Services, Inc. | Current |
Accepting new patients | |
| Baptist Medical Center - Yazoo, Inc | Current |
Accepting new patients | |
| Pontotoc Health Services, Inc. | Current |
Accepting new patients | |
| Baptist Medical Center - Yazoo, Inc | Current |
Accepting new patients | |
| Correct Care, Inc. | Current |
Accepting new patients | |
| G a Carmichael Family Health Center | Past | Accepting new patients | |
| Patients Choice Medical Center of Humphreys County, LLC | Past | Accepting new patients |
Locations
229 Saint John Ln
Covington, LA 70433
Phone (866) 875-9225
176 S Main St
Pontotoc, MS 38863
Phone (601) 489-5510
140 Burke Calhoun City Rd
Slate Spring, MS 38916
Phone (662) 628-6611
409 Tyler Holmes Dr
Winona, MS 38967
Phone (662) 283-3060
823 Grand Ave
Yazoo City, MS 39194
Phone (601) 746-2261
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 17099 | MS | Yes |
Addresses
Primary practice location
116 Hayden Street
Belzoni, MS 39038
Mailing address
116 Hayden St
Belzoni, MS 39038
Phone (601) 859-5213
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00124063 | Medicaid | MS | |
| 0124063 | Medicaid | MS |
Other names
- Shahzad Dailami-Pour
Other providers in Belzoni, MS
- Ollie M Chapman
- Cindy Ragland Ira
- Peggy Ann Clark
- Clarks Caring Hearts LLC
- Sharon Coney
- Daniel B. Story II, DMD
- Delta Valley Development Corp #2
- Elite Homecare and Staffing Solutions LLC
- Elite Homecare Solutions LLC
- First Care Homehealth Care LLC
All providers in Belzoni, MS · Family Medicine Physician in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 18, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.