Provider Demographics
NPI:1912220633
Name:JAVED, SHAZIA (MD)
Entity Type:Individual
Prefix:DR
First Name:SHAZIA
Middle Name:
Last Name:JAVED
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2514 67TH AVENUE LOOP
Mailing Address - Street 2:SUITE 112
Mailing Address - City:MERIDIAN
Mailing Address - State:MS
Mailing Address - Zip Code:39307-7259
Mailing Address - Country:US
Mailing Address - Phone:601-553-0707
Mailing Address - Fax:601-553-0775
Practice Address - Street 1:2514 67TH AVENUE LOOP
Practice Address - Street 2:SUITE 112
Practice Address - City:MERIDIAN
Practice Address - State:MS
Practice Address - Zip Code:39307-7259
Practice Address - Country:US
Practice Address - Phone:601-553-0707
Practice Address - Fax:601-553-0775
Is Sole Proprietor?:No
Enumeration Date:2010-03-09
Last Update Date:2010-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS20585207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine