Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | 63833 | MN |
N | 2086S0102X | Surgical Critical Care | 63833 | MN |
NPI | 1164842456 |
---|---|
Provider Name | Salma Shaker |
First Address | Burnsville, MN 55337-4590 |
Second Address | Burnsville, MN 55337-4590 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/04/2014 |
Last Update Date | 20/08/2019 |