Provider Demographics
NPI:1558454322
Name:MAROOF, SHAHEDA FATIMA (MD)
Entity Type:Individual
Prefix:MRS
First Name:SHAHEDA
Middle Name:FATIMA
Last Name:MAROOF
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4041 ED DR
Mailing Address - Street 2:#108
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27612-8004
Mailing Address - Country:US
Mailing Address - Phone:919-783-8377
Mailing Address - Fax:919-783-8770
Practice Address - Street 1:4041 ED DR
Practice Address - Street 2:#108
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27612-8004
Practice Address - Country:US
Practice Address - Phone:919-783-8377
Practice Address - Fax:919-783-8770
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2011-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC281142084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC12082OtherBCBS
NC8912082Medicaid