Basic Information
| Provider Information | |||||||||
| NPI: | 1124095062 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ENGINEER | ||||||||
| FirstName: | SHIRIN | ||||||||
| MiddleName: | F. | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 790058 | ||||||||
| Address2: | |||||||||
| City: | SAINT LOUIS | ||||||||
| State: | MO | ||||||||
| PostalCode: | 631790058 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6365492380 | ||||||||
| FaxNumber: | 3145695974 | ||||||||
| Practice Location | |||||||||
| Address1: | 2850 N RIDGE RD | ||||||||
| Address2: | |||||||||
| City: | ELLICOTT CITY | ||||||||
| State: | MD | ||||||||
| PostalCode: | 210433464 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4104811600 | ||||||||
| FaxNumber: | 4107507615 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/28/2006 | ||||||||
| LastUpdateDate: | 01/20/2010 | ||||||||
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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 | 207L00000X | D54623 | MD | Y | Allopathic & Osteopathic Physicians | Anesthesiology |
ID Information
| ID | Type | State | Issuer | Description | S417 0018 | 01 | DC | CAREFIRST BCBS | OTHER | KBC1CH | 01 | MD | CAREFIRST BCBS | OTHER |