Provider Demographics
NPI:1982148375
Name:SHAMARIE SAIS, MD, PC
Entity Type:Organization
Organization Name:SHAMARIE SAIS, MD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHAMARIE
Authorized Official - Middle Name:
Authorized Official - Last Name:SAIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:505-298-0301
Mailing Address - Street 1:3602 CAMPUS BLVD NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87106-1314
Mailing Address - Country:US
Mailing Address - Phone:505-404-8925
Mailing Address - Fax:505-404-8918
Practice Address - Street 1:3602 CAMPUS BLVD NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87106-1314
Practice Address - Country:US
Practice Address - Phone:505-404-8925
Practice Address - Fax:505-404-8918
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-05
Last Update Date:2017-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMMD2006-0142207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM2051796Medicaid