Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | MD60140499 | WA |
N | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | 2009-00480 | NC |
N | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | MD60140499 | WA |
NPI | 1801031307 |
---|---|
Provider Name | Dr. Khalid Shirzad |
First Address | Spokane, WA 99204-2715 |
Second Address | Spokane, WA 99204-2715 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/12/2008 |
Last Update Date | 28/02/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0263925 | WA LABOR & INDUSTRIES (01) | WA |
2008601 | (05) | WA |