Provider Demographics
NPI:1669761474
Name:SAIF, SHAKERA BINTE
Entity type:Individual
Prefix:
First Name:SHAKERA
Middle Name:BINTE
Last Name:SAIF
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 1:4520 ASHWORTH GLEN CT
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30068-2051
Mailing Address - Country:US
Mailing Address - Phone:205-759-2398
Mailing Address - Fax:
Practice Address - Street 1:780 CHURCH ST NE
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30060-7269
Practice Address - Country:US
Practice Address - Phone:770-422-2378
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-01
Last Update Date:2011-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH025627183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist