Provider Demographics
NPI:1124171756
Name:MAWJEE, SHAMSA Z (MD)
Entity type:Individual
Prefix:
First Name:SHAMSA
Middle Name:Z
Last Name:MAWJEE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SHAMSA
Other - Middle Name:
Other - Last Name:ZINDANI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9040A JACKSON AVE
Mailing Address - Street 2:JOINT BASE LEWIS-MCCHORD
Mailing Address - City:JBLM
Mailing Address - State:WA
Mailing Address - Zip Code:98431
Mailing Address - Country:US
Mailing Address - Phone:253-968-0770
Mailing Address - Fax:253-968-2826
Practice Address - Street 1:9040 JACKSON AVE
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98431-1700
Practice Address - Country:US
Practice Address - Phone:253-968-3885
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-18
Last Update Date:2024-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00044731207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8440851Medicaid
WAG8859696Medicare PIN
WAG8859697Medicare PIN
WAG8859693Medicare PIN
WAG8872456Medicare PIN
WA8440851Medicaid
WAG8859695Medicare PIN
WAG8859694Medicare PIN