Provider Demographics
NPI:1053140897
Name:SHONIBARE, SIDDHI (BIRTH DOULA DONA)
Entity type:Individual
Prefix:
First Name:SIDDHI
Middle Name:
Last Name:SHONIBARE
Suffix:
Gender:F
Credentials:BIRTH DOULA DONA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1317 EDGEWATER DR # 2019
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32804-6350
Mailing Address - Country:US
Mailing Address - Phone:919-418-0028
Mailing Address - Fax:
Practice Address - Street 1:700 ALEXAN DR APT 205
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27707-5934
Practice Address - Country:US
Practice Address - Phone:919-418-0028
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-30
Last Update Date:2024-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula