Provider Demographics
NPI:1700381266
Name:SHAHEEN, ZACHARY (MD/PHD)
Entity Type:Individual
Prefix:DR
First Name:ZACHARY
Middle Name:
Last Name:SHAHEEN
Suffix:
Gender:M
Credentials:MD/PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:M136, 1ST FLOOR, EAST BUILDING 8950A
Mailing Address - Street 2:2450 RIVERSIDE AVE
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55454
Mailing Address - Country:US
Mailing Address - Phone:612-624-4477
Mailing Address - Fax:
Practice Address - Street 1:2450 RIVERSIDE AVE RM M1361
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55454-1450
Practice Address - Country:US
Practice Address - Phone:763-229-7817
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-27
Last Update Date:2018-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program