Provider Demographics
NPI:1477712578
Name:KAO, SHIRIN ZM (MD)
Entity Type:Individual
Prefix:
First Name:SHIRIN
Middle Name:ZM
Last Name:KAO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SHIRIN
Other - Middle Name:ZEHRA
Other - Last Name:MADAD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:510 BUTLER AVE
Mailing Address - Street 2:5B100 RM 102
Mailing Address - City:MARTINSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:25405-9990
Mailing Address - Country:US
Mailing Address - Phone:304-263-0811
Mailing Address - Fax:304-262-1390
Practice Address - Street 1:510 BUTLER AVE
Practice Address - Street 2:5B100 RM 102
Practice Address - City:MARTINSBURG
Practice Address - State:WV
Practice Address - Zip Code:25405-9990
Practice Address - Country:US
Practice Address - Phone:304-263-0811
Practice Address - Fax:304-262-1390
Is Sole Proprietor?:No
Enumeration Date:2008-06-03
Last Update Date:2010-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD038033207RG0300X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine