Active NPI
Mahmoud S. Shaker, B. SC PH D
- Pharmacist
- Saint Paul, MN
National Provider Identifier
1205105129
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 116530
- Practice address
- 2387 Highway 10
Saint Paul, MN 55112-4967 - Phone
- (651) 631-0673
- NPI assigned
- Dec 21, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 116530 | MN | Primary |
Addresses
Primary practice location
2387 Highway 10
Saint Paul, MN 55112-4967
Mailing address
1995 Skillman Ave W
Roseville, MN 55113-5445
Phone (651) 631-0673
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 116530 | MN | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1324425600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1324425600000",
"number": "1205105129",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1995 SKILLMAN AVE W",
"city": "ROSEVILLE",
"state": "MN",
"postal_code": "551135445",
"telephone_number": "651-631-0673"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2387 HIGHWAY 10",
"city": "SAINT PAUL",
"state": "MN",
"postal_code": "551124967",
"telephone_number": "651-631-0673"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHAKER",
"first_name": "MAHMOUD",
"middle_name": "S.",
"credential": "B. SC PH D",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-12-21",
"last_updated": "2011-12-21",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MN",
"license": "116530",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Paul, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.