Provider Demographics
NPI:1124649033
Name:HAIB, SHURUK (MD)
Entity type:Individual
Prefix:
First Name:SHURUK
Middle Name:
Last Name:HAIB
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Middle Name:
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Mailing Address - Street 1:2216 E 32ND ST STE 101
Mailing Address - Street 2:
Mailing Address - City:JOPLIN
Mailing Address - State:MO
Mailing Address - Zip Code:64804-3015
Mailing Address - Country:US
Mailing Address - Phone:417-556-2780
Mailing Address - Fax:417-556-2781
Practice Address - Street 1:2216 E 32ND ST STE 101
Practice Address - Street 2:
Practice Address - City:JOPLIN
Practice Address - State:MO
Practice Address - Zip Code:64804-3015
Practice Address - Country:US
Practice Address - Phone:417-556-2780
Practice Address - Fax:417-556-2781
Is Sole Proprietor?:No
Enumeration Date:2020-05-01
Last Update Date:2023-07-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO2023026694207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine