Provider Demographics
NPI:1942876636
Name:KANG, ZAHRA SHABIR
Entity Type:Individual
Prefix:
First Name:ZAHRA
Middle Name:SHABIR
Last Name:KANG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1019 W SAGINAW ST
Mailing Address - Street 2:
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48915-1966
Mailing Address - Country:US
Mailing Address - Phone:517-374-6103
Mailing Address - Fax:517-374-0986
Practice Address - Street 1:1019 W SAGINAW ST
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48915-1966
Practice Address - Country:US
Practice Address - Phone:517-374-6103
Practice Address - Fax:517-374-0986
Is Sole Proprietor?:No
Enumeration Date:2021-06-02
Last Update Date:2021-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5303033342183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician