MEDICARE: SHAHR BANOO REZAIE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	374J00000X	Doula

General Provider Information

NPI Number	:	1679438204
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHAHR BANOO REZAIE

Provider Business Mailing Address
First Line	:	2685 S DAYTON WAY APT 81
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80231-3972
Country	:	US
Telephone Number	:	720-984-0688
Fax Number	:

Provider Business Practice Location Address
First Line	:	2685 S DAYTON WAY APT 81
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80231-3972
Country	:	US
Telephone Number	:	720-984-0688
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/16/2025
Last Update Date	:	12/16/2025

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Directions to “ SHAHR BANOO REZAIE ” Practice Location

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