Provider Demographics
NPI:1821301441
Name:SHAPERA, MARIAM AFRAM (MD)
Entity Type:Individual
Prefix:DR
First Name:MARIAM
Middle Name:AFRAM
Last Name:SHAPERA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:MARIAM
Other - Middle Name:
Other - Last Name:SHAPERA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:1536 GRANITE HILLS DR
Mailing Address - Street 2:UNIT A
Mailing Address - City:EL CAJON
Mailing Address - State:CA
Mailing Address - Zip Code:92019-6221
Mailing Address - Country:US
Mailing Address - Phone:313-920-2050
Mailing Address - Fax:
Practice Address - Street 1:4647 ZION AVE
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92120-2507
Practice Address - Country:US
Practice Address - Phone:619-528-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-24
Last Update Date:2021-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301094564207Q00000X
CAA132446207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine