MEDICARE: HUDA SHAIKH PA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant
2	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1659842888
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HUDA SHAIKH PA-C

Provider Business Mailing Address
First Line	:	3005 NEW HERMITAGE CT
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23228-2785
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7611 FOREST AVE STE 250
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23229-4947
Country	:	US
Telephone Number	:	607-592-9130
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/16/2018
Last Update Date	:	02/22/2022

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