Provider Demographics
NPI:1952412579
Name:SHAKOOR, KARIM K (MD)
Entity type:Individual
Prefix:DR
First Name:KARIM
Middle Name:K
Last Name:SHAKOOR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1380 MILSTEAD AVE NE
Mailing Address - Street 2:SUITE C
Mailing Address - City:CONYERS
Mailing Address - State:GA
Mailing Address - Zip Code:30012-3864
Mailing Address - Country:US
Mailing Address - Phone:770-922-7000
Mailing Address - Fax:770-922-8070
Practice Address - Street 1:1380 MILSTEAD AVE NE
Practice Address - Street 2:SUITE C
Practice Address - City:CONYERS
Practice Address - State:GA
Practice Address - Zip Code:30012-3864
Practice Address - Country:US
Practice Address - Phone:770-922-7000
Practice Address - Fax:770-922-8070
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2013-01-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA43282207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00751352BMedicaid
GA00751352BMedicaid
GA11BDSJKMedicare PIN