Provider Demographics
NPI:1639548886
Name:RAHIMI - SHAHMIRZADI, SHIVA (MD)
Entity Type:Individual
Prefix:MRS
First Name:SHIVA
Middle Name:
Last Name:RAHIMI - SHAHMIRZADI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3435 MAIN ST.
Mailing Address - Street 2:105 PARK HALL SOUTH CAMPUS
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14216
Mailing Address - Country:US
Mailing Address - Phone:716-838-5889
Mailing Address - Fax:716-838-4918
Practice Address - Street 1:3435 MAIN ST.
Practice Address - Street 2:105 PARK HALL SOUTH CAMPUS
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14216
Practice Address - Country:US
Practice Address - Phone:716-838-5889
Practice Address - Fax:716-838-4918
Is Sole Proprietor?:No
Enumeration Date:2015-09-17
Last Update Date:2016-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program