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General NPI Number Information
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NPI Number | 1225013006
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Entity Type | Individual
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Provider Name | ATIA SHIREEN HASHIM M.D.
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Gender | Female
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Dates
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Enumeration Date | 12/14/2005
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Last Update Date | 06/09/2021
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Provider Practice Location Address
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Address Line | 311 W COUNTRY CLUB RD STE 1
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City | ROSWELL
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State | NM
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Zip | 88201-5839
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Country | US
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Telephone | 575-623-2836
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Fax | 575-623-2841
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Provider Business Mailing Address
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Address Line | 311 W COUNTRY CLUB RD STE 1
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City | ROSWELL
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State | NM
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Zip | 88201-5839
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Country | US
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Telephone | 575-623-2836
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Fax | 575-623-2841
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | MD0728731
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 35.142228
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | MD2015-0409
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License Number State | NM
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