Individual
DR. TARIQ SHAKOOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1836 SOUTH AVE, LA CROSSE, WI 54601-5429
(608) 782-7300
Mailing address
4685 FOREST AVE, CINCINNATI, OH 45212-3397
(513) 853-4722
(513) 852-8525
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
32055
WI
207RG0100X
Gastroenterology Physician
Primary
35.048678
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0675854
—
OH
05
—
100378150
—
IN
01
—
110083909
RAILROAD MEDICARE
OH
01
—
110086575
RAILROAD MEDICARE
IN
05
—
64864721
—
KY
Enumeration date
07/21/2005
Last updated
05/17/2021
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