Provider Demographics
NPI:1164842456
Name:SHAKER, SALMA (MD)
Entity Type:Individual
Prefix:
First Name:SALMA
Middle Name:
Last Name:SHAKER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14101 FAIRVIEW DR
Mailing Address - Street 2:
Mailing Address - City:BURNSVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55337-4590
Mailing Address - Country:US
Mailing Address - Phone:952-993-3282
Mailing Address - Fax:
Practice Address - Street 1:14101 FAIRVIEW DR
Practice Address - Street 2:
Practice Address - City:BURNSVILLE
Practice Address - State:MN
Practice Address - Zip Code:55337-4590
Practice Address - Country:US
Practice Address - Phone:952-993-3282
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-24
Last Update Date:2019-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN638332086S0102X, 207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No2086S0102XAllopathic & Osteopathic PhysiciansSurgerySurgical Critical Care