Provider Demographics
NPI:1720353923
Name:TEJANI, SHAMIM (PHARMD)
Entity Type:Individual
Prefix:
First Name:SHAMIM
Middle Name:
Last Name:TEJANI
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15317 W BELL RD
Mailing Address - Street 2:SUITE 106
Mailing Address - City:SURPRISE
Mailing Address - State:AZ
Mailing Address - Zip Code:85374-3877
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:15317 W BELL RD
Practice Address - Street 2:SUITE 106
Practice Address - City:SURPRISE
Practice Address - State:AZ
Practice Address - Zip Code:85374-3877
Practice Address - Country:US
Practice Address - Phone:623-544-5190
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-21
Last Update Date:2012-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS0147901835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist