Organization
ADOLESCENT,CHILD & ADULT PSYCHIATRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHAHEDA FATIMA MAROOF M.D. (PSYCHIATRIST)
(919) 783-8377
Entity
Organization
Contact information
Practice address
4041 ED DR # 108, RALEIGH, NC 27612-8089
(919) 783-8377
(866) 347-8377
Mailing address
4041 ED DR # 108, RALEIGH, NC 27612-8089
(919) 783-8377
(866) 347-8377
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
28114
NC
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
28114
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12082
BLUE CROSS BLUE SHIELD OF NORTH CAROLINA
NC
05
—
8912082
—
NC
Enumeration date
05/27/2008
Last updated
05/27/2008
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