Provider Demographics
NPI:1194954826
Name:SHAKIR, IMRAN M (DO)
Entity type:Individual
Prefix:DR
First Name:IMRAN
Middle Name:M
Last Name:SHAKIR
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:30 SEVERANCE CIR
Mailing Address - Street 2:APARTMENT 502
Mailing Address - City:CLEVELAND HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44118-1531
Mailing Address - Country:US
Mailing Address - Phone:630-440-7738
Mailing Address - Fax:
Practice Address - Street 1:10524 EUCLID AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44106-2205
Practice Address - Country:US
Practice Address - Phone:216-844-3450
Practice Address - Fax:216-201-4203
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-01
Last Update Date:2012-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0361297672084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry