Individual
MAASI SHAMILOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
765 E ROUTE 70 BLDG 100-A, MARLTON, NJ 08053-2341
(856) 983-3900
(856) 810-0110
Mailing address
5 STEAD CT, VOORHEES, NJ 08043-4121
(856) 489-1630
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
25MA06509800
NJ
2084P0804X
Child & Adolescent Psychiatry Physician
MA 65098
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7270402
—
NJ
Enumeration date
07/29/2006
Last updated
10/27/2015
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