Provider Demographics
NPI:1225778244
Name:ZARDOOST, SHIRLEY NICOLETTE
Entity Type:Individual
Prefix:
First Name:SHIRLEY
Middle Name:NICOLETTE
Last Name:ZARDOOST
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SHIRLEY
Other - Middle Name:NICOLETTE
Other - Last Name:PAYSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2030 STRINGTOWN RD STE 300
Mailing Address - Street 2:
Mailing Address - City:GROVE CITY
Mailing Address - State:OH
Mailing Address - Zip Code:43123-3993
Mailing Address - Country:US
Mailing Address - Phone:614-544-0176
Mailing Address - Fax:614-544-1981
Practice Address - Street 1:2030 STRINGTOWN RD STE 300
Practice Address - Street 2:
Practice Address - City:GROVE CITY
Practice Address - State:OH
Practice Address - Zip Code:43123-3993
Practice Address - Country:US
Practice Address - Phone:614-544-0176
Practice Address - Fax:614-544-1981
Is Sole Proprietor?:No
Enumeration Date:2022-03-29
Last Update Date:2022-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program