Provider Demographics
NPI:1942576178
Name:GRANT, SHAKIRA J (MBBS)
Entity Type:Individual
Prefix:DR
First Name:SHAKIRA
Middle Name:J
Last Name:GRANT
Suffix:
Gender:F
Credentials:MBBS
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Mailing Address - Street 1:3161 HOUPT BUILDING 170 MANNING DRIVE
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27599-0001
Mailing Address - Country:US
Mailing Address - Phone:919-966-2891
Mailing Address - Fax:919-966-6735
Practice Address - Street 1:3161 HOUPT BUILDING 170 MANNING DRIVE
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27599-0001
Practice Address - Country:US
Practice Address - Phone:919-966-2891
Practice Address - Fax:919-966-6735
Is Sole Proprietor?:No
Enumeration Date:2012-04-02
Last Update Date:2021-01-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD456197207RG0300X
NC2020-04330207RG0300X, 207RH0000X, 207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
No207RH0000XAllopathic & Osteopathic PhysiciansInternal MedicineHematology