Provider Demographics
NPI:1881685428
Name:SHAHRIER, MAMUN (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:MAMUN
Middle Name:
Last Name:SHAHRIER
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 1:626 N BICKETT BLVD
Mailing Address - Street 2:
Mailing Address - City:LOUISBURG
Mailing Address - State:NC
Mailing Address - Zip Code:27549-2314
Mailing Address - Country:US
Mailing Address - Phone:919-496-2745
Mailing Address - Fax:919-496-3888
Practice Address - Street 1:626 N BICKETT BLVD
Practice Address - Street 2:
Practice Address - City:LOUISBURG
Practice Address - State:NC
Practice Address - Zip Code:27549-2314
Practice Address - Country:US
Practice Address - Phone:919-496-2745
Practice Address - Fax:919-496-3888
Is Sole Proprietor?:No
Enumeration Date:2005-11-02
Last Update Date:2008-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89134JUMedicaid
NCP00055459OtherRAILROAD MEDICARE
NC134JUOtherBCBS NC
NC2018830AMedicare PIN
NC89134JUMedicaid