Provider Demographics
NPI:1922688654
Name:FATIMA, SHAHROZ (MD/MPHS)
Entity Type:Individual
Prefix:DR
First Name:SHAHROZ
Middle Name:
Last Name:FATIMA
Suffix:
Gender:F
Credentials:MD/MPHS
Other - Prefix:
Other - First Name:SHAROZ
Other - Middle Name:
Other - Last Name:FATIMA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:593 EDDY ST
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02903-4923
Mailing Address - Country:US
Mailing Address - Phone:401-793-2695
Mailing Address - Fax:401-444-4165
Practice Address - Street 1:593 EDDY ST
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02903-4923
Practice Address - Country:US
Practice Address - Phone:401-793-2695
Practice Address - Fax:401-444-4165
Is Sole Proprietor?:No
Enumeration Date:2021-04-08
Last Update Date:2024-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program