Provider Demographics
NPI:1851895924
Name:SHAKIR, MOHAMMED SAEB
Entity Type:Individual
Prefix:MR
First Name:MOHAMMED
Middle Name:SAEB
Last Name:SHAKIR
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1806 GLENDALE DR SW
Mailing Address - Street 2:
Mailing Address - City:WILSON
Mailing Address - State:NC
Mailing Address - Zip Code:27893-4402
Mailing Address - Country:US
Mailing Address - Phone:800-243-0566
Mailing Address - Fax:252-243-1347
Practice Address - Street 1:110 BARCELONA DR
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28303-4453
Practice Address - Country:US
Practice Address - Phone:800-243-0566
Practice Address - Fax:252-243-1347
Is Sole Proprietor?:No
Enumeration Date:2018-03-22
Last Update Date:2022-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0010-08026363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant