Provider Demographics
NPI:1316093248
Name:NASSIRPOUR, SHAHIN (DC)
Entity type:Individual
Prefix:DR
First Name:SHAHIN
Middle Name:
Last Name:NASSIRPOUR
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 MINTE DR
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21236-1600
Mailing Address - Country:US
Mailing Address - Phone:410-663-1000
Mailing Address - Fax:410-663-2777
Practice Address - Street 1:7110 BELAIR RD
Practice Address - Street 2:SUITE 220
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21206-1125
Practice Address - Country:US
Practice Address - Phone:410-663-1000
Practice Address - Fax:410-663-2777
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor