Provider Demographics
NPI:1497958441
Name:ZAWAHIR, SHAMILA BALKIS (MB, BS)
Entity Type:Individual
Prefix:
First Name:SHAMILA
Middle Name:BALKIS
Last Name:ZAWAHIR
Suffix:
Gender:F
Credentials:MB, BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:350 ENGLE ST # 3EAST
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07631-1808
Mailing Address - Country:US
Mailing Address - Phone:201-894-3000
Mailing Address - Fax:201-894-5264
Practice Address - Street 1:350 ENGLE ST
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07631-1808
Practice Address - Country:US
Practice Address - Phone:201-608-2775
Practice Address - Fax:201-894-5286
Is Sole Proprietor?:No
Enumeration Date:2007-06-07
Last Update Date:2022-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD710202080P0206X
NY2895642080P0206X
NJ25MA101465002080P0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0206XAllopathic & Osteopathic PhysiciansPediatricsPediatric Gastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD510621400Medicaid
NJ0641618Medicaid