Provider Demographics
NPI:1225013006
Name:HASHIM, ATIA SHIREEN (MD)
Entity Type:Individual
Prefix:DR
First Name:ATIA
Middle Name:SHIREEN
Last Name:HASHIM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:311 W COUNTRY CLUB RD
Mailing Address - Street 2:STE 1
Mailing Address - City:ROSWELL
Mailing Address - State:NM
Mailing Address - Zip Code:88201-5839
Mailing Address - Country:US
Mailing Address - Phone:575-623-2836
Mailing Address - Fax:575-623-2841
Practice Address - Street 1:311 W COUNTRY CLUB RD
Practice Address - Street 2:STE 1
Practice Address - City:ROSWELL
Practice Address - State:NM
Practice Address - Zip Code:88201-5839
Practice Address - Country:US
Practice Address - Phone:575-623-2836
Practice Address - Fax:575-623-2841
Is Sole Proprietor?:No
Enumeration Date:2005-12-14
Last Update Date:2021-06-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD0728731207RG0100X
OH35.142228207RG0100X
NMMD2015-0409207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA101365260Medicaid
PA16079OtherBRAVO ELDER HEALTH
PA1789361OtherHIGHMARK
PA2626477000OtherINDEPENDENCE BLUE CROSS
PA30027180OtherKEYSTONE MERCY
PAP00294987OtherRR MEDICARE
PA13361OtherHEALTH PARTNERS
NM45854823Medicaid
PA0003093101OtherAMERICHOICE
PA0003093101OtherAMERICHOICE
PA2626477000OtherINDEPENDENCE BLUE CROSS
NM426081YM5AMedicare PIN