Individual
DR. MIRAM SHAHEEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
600 MARSHALL ST UNIT 128, LOUISVILLE, KY 40202-3618
(502) 572-9251
Mailing address
600 MARSHALL ST UNIT 128, LOUISVILLE, KY 40202-3618
(502) 572-9251
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
10256
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
S19259185
DRIVER'S LICENSE
KY
Enumeration date
10/19/2020
Last updated
10/19/2020
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