Provider Demographics
NPI:1942644588
Name:NOORUDEEN, SHAJEER (DO)
Entity Type:Individual
Prefix:
First Name:SHAJEER
Middle Name:
Last Name:NOORUDEEN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 980276
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23298-0276
Mailing Address - Country:US
Mailing Address - Phone:804-628-2616
Mailing Address - Fax:804-628-5536
Practice Address - Street 1:1000 E BROAD ST # 5-104
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23219-1930
Practice Address - Country:US
Practice Address - Phone:804-628-2616
Practice Address - Fax:804-628-5536
Is Sole Proprietor?:No
Enumeration Date:2013-04-25
Last Update Date:2016-06-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA01160289802080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine