Basic Information
| Provider Information | |||||||||
| NPI: | 1740212224 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | SHURBAJI | ||||||||
| FirstName: | MUHAMMAD | ||||||||
| MiddleName: | S | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | DEPT. OF PATHOLOGY ETSU | ||||||||
| Address2: | P.O. BOX 70568 | ||||||||
| City: | JOHNSON CITY | ||||||||
| State: | TN | ||||||||
| PostalCode: | 37614 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4234396210 | ||||||||
| FaxNumber: | 4234398060 | ||||||||
| Practice Location | |||||||||
| Address1: | DOGWOOD AVE, VAMC BLDG #1 | ||||||||
| Address2: | DEPT. OF PATHOLOGY ETSU | ||||||||
| City: | JOHNSON CITY | ||||||||
| State: | TN | ||||||||
| PostalCode: | 37614 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4234396210 | ||||||||
| FaxNumber: | 4234398060 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/07/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207ZP0102X | MD0000020985 | TN | Y | Allopathic & Osteopathic Physicians | Pathology | Anatomic Pathology & Clinical Pathology |
No ID Information.