MEDICARE: SHAIKH INTERNATIONAL MEDICINE, LLC

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	207R00000X	Internal Medicine Physician	ME45832	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1811391345
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SHAIKH INTERNATIONAL MEDICINE, LLC

Provider Business Mailing Address
First Line	:	2504 ACORN ST, STUITE A
Second Line	:
City	:	FT PIERCE
State	:	FL
Zip	:	34947
Country	:	US
Telephone Number	:	772-466-1112
Fax Number	:	772-466-1184

Provider Business Practice Location Address
First Line	:	2504 ACORN ST, SUITE A
Second Line	:
City	:	FT PIERCE
State	:	FL
Zip	:	34947
Country	:	US
Telephone Number	:	772-466-1112
Fax Number	:	772-466-1184

Authorized Official
Title or Position	:	DR
Name	:	MR. LIAQUDDIN SHAIKH
Credential	:	MD
Telephone Number	:	772-466-1112

Provider Enumeration Date	:	10/13/2014
Last Update Date	:	10/13/2014

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