Provider Demographics
NPI:1972983781
Name:HORIZON SURGERY CLINIC
Entity type:Organization
Organization Name:HORIZON SURGERY CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL SURGEON
Authorized Official - Prefix:DR
Authorized Official - First Name:MAHA
Authorized Official - Middle Name:S
Authorized Official - Last Name:SHAKIR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:503-708-8285
Mailing Address - Street 1:2557 SOUTHSHORE BLVD
Mailing Address - Street 2:
Mailing Address - City:LAKE OSWEGO
Mailing Address - State:OR
Mailing Address - Zip Code:97034-5761
Mailing Address - Country:US
Mailing Address - Phone:503-708-8285
Mailing Address - Fax:
Practice Address - Street 1:6542 SE LAKE RD STE 101
Practice Address - Street 2:
Practice Address - City:MILWAUKIE
Practice Address - State:OR
Practice Address - Zip Code:97222-2245
Practice Address - Country:US
Practice Address - Phone:503-708-8285
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-05
Last Update Date:2015-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD27868208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty