Provider Demographics
NPI:1982903779
Name:SHAKER, HEBA SAMI
Entity Type:Individual
Prefix:MRS
First Name:HEBA
Middle Name:SAMI
Last Name:SHAKER
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 1:502 BRIARDALE AVE
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27519-2881
Mailing Address - Country:US
Mailing Address - Phone:919-466-7200
Mailing Address - Fax:
Practice Address - Street 1:1200 NW MAYNARD RD
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27513-8719
Practice Address - Country:US
Practice Address - Phone:919-469-6087
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-20
Last Update Date:2011-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC13983183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist