Provider Demographics
NPI:1114698727
Name:SHAHAB, AREEN A (PHARMD)
Entity Type:Individual
Prefix:
First Name:AREEN
Middle Name:A
Last Name:SHAHAB
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 ENCHANTED CT APT 3
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:MO
Mailing Address - Zip Code:63021-5458
Mailing Address - Country:US
Mailing Address - Phone:314-695-7232
Mailing Address - Fax:
Practice Address - Street 1:215 ENCHANTED CT APT 3
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:MO
Practice Address - Zip Code:63021-5458
Practice Address - Country:US
Practice Address - Phone:314-695-7232
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-23
Last Update Date:2021-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2021038960183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist