Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | APRN.CNP.025494 | OH |
NPI | 1003281064 |
---|---|
Provider Name | Rashid Shaibu |
First Address | Columbus, OH 43219-2289 |
Second Address | Columbus, OH 43219-1002 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/12/2015 |
Last Update Date | 20/02/2020 |