Provider Demographics
NPI:1861451452
Name:SHAKIR, AHMAR (DO)
Entity type:Individual
Prefix:
First Name:AHMAR
Middle Name:
Last Name:SHAKIR
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 CAPITAL WAY STE 356
Mailing Address - Street 2:
Mailing Address - City:PENNINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08534-2521
Mailing Address - Country:US
Mailing Address - Phone:609-537-6000
Mailing Address - Fax:609-537-6002
Practice Address - Street 1:2 CAPITAL WAY STE 356
Practice Address - Street 2:
Practice Address - City:PENNINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08534-2521
Practice Address - Country:US
Practice Address - Phone:609-537-6000
Practice Address - Fax:609-537-6002
Is Sole Proprietor?:No
Enumeration Date:2006-03-21
Last Update Date:2023-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ76043207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0026484Medicaid
NJ8441828OtherAETNA
NJ0026484Medicaid
NJH94612Medicare UPIN