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1932212230
SHAISTA KHANUM
AUGUSTA, ME
NPI
1932212230
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
207Q00000X Family Medicine
(Licence: ME EC061112)
Enumeration Date
2006-08-17
Last Update Date
2007-07-08
Business Address
-- SHAISTA KHANUM MD
15 E CHESTNUT ST
AUGUSTA, ME 04330-5736
Phone number: 207-626-1561
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Mailing Address
-- SHAISTA KHANUM MD
150 DRESDEN AVE
GARDINER, ME 04345-2615
Phone number: 207-621-9337
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