Provider Demographics
NPI:1356684419
Name:ABDEL-MALEK, SHAHIR NEHAD
Entity Type:Individual
Prefix:DR
First Name:SHAHIR
Middle Name:NEHAD
Last Name:ABDEL-MALEK
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3555 LOUISIANA AVE S
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55426-4121
Mailing Address - Country:US
Mailing Address - Phone:202-280-4401
Mailing Address - Fax:
Practice Address - Street 1:3555 LOUISIANA AVE S
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS PARK
Practice Address - State:MN
Practice Address - Zip Code:55426-4121
Practice Address - Country:US
Practice Address - Phone:202-280-4401
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-27
Last Update Date:2014-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNS841223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics