Provider Demographics
NPI:1689792830
Name:SHAKIR, MOHAMAD A (MD)
Entity Type:Individual
Prefix:DR
First Name:MOHAMAD
Middle Name:A
Last Name:SHAKIR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:805 CHESTNUT ST
Mailing Address - Street 2:
Mailing Address - City:ROANOKE RAPIDS
Mailing Address - State:NC
Mailing Address - Zip Code:27870-3154
Mailing Address - Country:US
Mailing Address - Phone:252-541-1284
Mailing Address - Fax:252-541-1284
Practice Address - Street 1:1385 MEDICAL CENTER DR
Practice Address - Street 2:
Practice Address - City:ROANOKE RAPIDS
Practice Address - State:NC
Practice Address - Zip Code:27870-5130
Practice Address - Country:US
Practice Address - Phone:252-537-9176
Practice Address - Fax:252-537-6851
Is Sole Proprietor?:No
Enumeration Date:2007-03-27
Last Update Date:2014-07-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC2007-01840207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine