Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | 81755 | AZ |
N | 207VX0201X | Gynecologic Oncologist | 2635141 | NY |
Y | 207VX0201X | Gynecologic Oncologist | 311892 | LA |
N | 207VX0201X | Gynecologic Oncologist | ME120013 | FL |
NPI | 1073788634 |
---|---|
Provider Name | Shazia Bashir |
First Address | Jacksonville, FL 32256-6932 |
Second Address | Baton Rouge, LA 70817-5128 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/04/2008 |
Last Update Date | 02/05/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
011918400 | (05) | FL |
14V2G | BCBS (01) | FL |
2492292 | (05) | LA |
374161 | AVMED (01) | FL |
4757984 | AETNA (01) | FL |