Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | M-14200 | ID |
N | 111NI0900X | Internist | M-14200 | ID |
Y | 207RE0101X | Endocrinologist (Diabetes Doctor) | M-14200 | ID |
NPI | 1083980734 |
---|---|
Provider Name | Shanaz Sikder |
First Address | Boise, ID 83702-6968 |
Second Address | Boise, ID 83702 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/03/2012 |
Last Update Date | 22/05/2018 |