Individual
SHAKEELA F MIRZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
4301064234
MI
2080A0000X
Pediatric Adolescent Medicine Physician
4301064234
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0E011720
BCBS GROUP NUMBER
MI
05
—
3383980
—
MI
05
—
4172282
—
MI
Enumeration date
05/12/2006
Last updated
03/01/2011
Update your record
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