Basic Information
| Provider Information | |||||||||
| NPI: | 1598076515 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ZAHR | ||||||||
| FirstName: | ROULA | ||||||||
| MiddleName: | SHRAIKY | ||||||||
| NamePrefix: | |||||||||
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| Credential: | M.D. | ||||||||
| OtherOrganizationName: | |||||||||
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| OtherLastName: | SHRAIKY | ||||||||
| OtherFirstName: | ROULA | ||||||||
| OtherMiddleName: | FAROUK | ||||||||
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| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | SAM JACKSON PARK ROAD SW | ||||||||
| Address2: | DEPARTMENT OF INTERNAL MEDICINE, ENDOCRINOLOGY DIVISION | ||||||||
| City: | PORTLAND | ||||||||
| State: | OR | ||||||||
| PostalCode: | 97239 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5034943273 | ||||||||
| FaxNumber: | 5034182208 | ||||||||
| Practice Location | |||||||||
| Address1: | SAM JACKSON PARK ROAD SW | ||||||||
| Address2: | DEPARTMENT OF INTERNAL MEDICINE, ENDOCRINOLOGY DIVISION | ||||||||
| City: | PORTLAND | ||||||||
| State: | OR | ||||||||
| PostalCode: | 97239 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5034943273 | ||||||||
| FaxNumber: | 5034182208 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/24/2010 | ||||||||
| LastUpdateDate: | 01/06/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | R-09644 | IA | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207RE0101X | 42698 | IA | N | Allopathic & Osteopathic Physicians | Internal Medicine | Endocrinology, Diabetes & Metabolism | 207RE0101X | MD-42698 | IA | N | Allopathic & Osteopathic Physicians | Internal Medicine | Endocrinology, Diabetes & Metabolism | 207RE0101X | MD179712 | OR | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Endocrinology, Diabetes & Metabolism | 390200000X | MT197992 | PA | N | Student, Health Care | Student in an Organized Health Care Education/Training Program |
No ID Information.