Provider Demographics
NPI:1992540371
Name:NAIMI SHIRAZI, KIAN DANIEL
Entity type:Individual
Prefix:
First Name:KIAN
Middle Name:DANIEL
Last Name:NAIMI SHIRAZI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6909 MOHAWK LN
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46260-4016
Mailing Address - Country:US
Mailing Address - Phone:317-966-8805
Mailing Address - Fax:
Practice Address - Street 1:6909 MOHAWK LN
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46260-4016
Practice Address - Country:US
Practice Address - Phone:317-966-8805
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-27
Last Update Date:2024-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program