Provider Demographics
NPI:1639369960
Name:SHAMS, AMEER Z (MD)
Entity type:Individual
Prefix:
First Name:AMEER
Middle Name:Z
Last Name:SHAMS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1050 W 10TH ST
Mailing Address - Street 2:
Mailing Address - City:ROLLA
Mailing Address - State:MO
Mailing Address - Zip Code:65401-2905
Mailing Address - Country:US
Mailing Address - Phone:573-364-9000
Mailing Address - Fax:
Practice Address - Street 1:1000 GW LN
Practice Address - Street 2:
Practice Address - City:WAYNESVILLE
Practice Address - State:MO
Practice Address - Zip Code:65583-2339
Practice Address - Country:US
Practice Address - Phone:573-774-2715
Practice Address - Fax:573-202-2410
Is Sole Proprietor?:No
Enumeration Date:2007-08-01
Last Update Date:2025-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-44015207Q00000X
MO2010026627207Q00000X
CAA122449207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS200684810AMedicaid
MO1639369960Medicaid
PA1020308340003Medicaid
PAP00702158Medicare PIN
MO701000066Medicare PIN
KS200684810AMedicaid
PA116680R7RMedicare PIN