Individual
SHAHZAIB TARIQ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3100 CHANNING WAY, IDAHO FALLS, ID 83404-7533
(208) 529-6111
Mailing address
3100 CHANNING WAY, IDAHO FALLS, ID 83404-7533
(208) 529-6111
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
M17001
ID
390200000X
Student in an Organized Health Care Education/Training Program
MT218730
PA
Other
Enumeration date
07/09/2019
Last updated
06/21/2023
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