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General NPI Number Information
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NPI Number | 1972983781
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Entity Type | Organization
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Legal Business Name | HORIZON SURGERY CLINIC
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Dates
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Enumeration Date | 06/05/2015
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Last Update Date | 06/05/2015
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Provider Practice Location Address
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Address Line | 6542 SE LAKE RD STE 101
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City | MILWAUKIE
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State | OR
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Zip | 97222-2245
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Country | US
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Telephone | 503-708-8285
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Fax |
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Provider Business Mailing Address
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Address Line | 2557 SOUTHSHORE BLVD
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City | LAKE OSWEGO
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State | OR
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Zip | 97034-5761
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Country | US
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Telephone | 503-708-8285
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Fax |
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Authorized Official
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Title or Position | GENERAL SURGEON
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Name | DR. MAHA S SHAKIR
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Credential | MD
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Telephone | 503-708-8285
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | MD27868
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License Number State | OR
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