Provider Demographics
NPI:1417704727
Name:SHABBIR, AISHA (MD)
Entity type:Individual
Prefix:MISS
First Name:AISHA
Middle Name:
Last Name:SHABBIR
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 EAST RIVER PARKWAY
Mailing Address - Street 2:VCRC 1ST FLOOR, SUITE 131
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55455
Mailing Address - Country:US
Mailing Address - Phone:612-626-3107
Mailing Address - Fax:
Practice Address - Street 1:401 EAST RIVER PARKWAY
Practice Address - Street 2:VCRC 1ST FLOOR, SUITE 131
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55455
Practice Address - Country:US
Practice Address - Phone:612-626-3107
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-03
Last Update Date:2025-02-24
Deactivation Date:2025-01-09
Deactivation Code:
Reactivation Date:2025-02-24
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program