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General NPI Number Information
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NPI Number | 1912084674
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Entity Type | Individual
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Provider Name | SHABBIR S DAWOODBHAI RPH
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Gender | Male
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Dates
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Enumeration Date | 11/01/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 870 GRAND AVE
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City | SAINT PAUL
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State | MN
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Zip | 55105-3291
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Country | US
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Telephone | 651-225-2883
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Fax | 651-225-2890
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Provider Business Mailing Address
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Address Line | 6927 COLLINGWOOD LN APT 7
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City | WOODBURY
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State | MN
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Zip | 55125-2123
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Country | US
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Telephone | 651-739-9519
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Fax |
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 116648-0
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License Number State | MN
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