Provider Demographics
NPI:1417953746
Name:SHIMON, ABIGAIL (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:ABIGAIL
Middle Name:
Last Name:SHIMON
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 1:227 TERRACE DR
Mailing Address - Street 2:
Mailing Address - City:WAUKEE
Mailing Address - State:IA
Mailing Address - Zip Code:50263-8509
Mailing Address - Country:US
Mailing Address - Phone:515-987-5712
Mailing Address - Fax:
Practice Address - Street 1:1128 SUNSET DR
Practice Address - Street 2:
Practice Address - City:NORWALK
Practice Address - State:IA
Practice Address - Zip Code:50211-1340
Practice Address - Country:US
Practice Address - Phone:515-981-0139
Practice Address - Fax:515-981-0608
Is Sole Proprietor?:No
Enumeration Date:2005-06-22
Last Update Date:2009-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA20730183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist