Healthcare Provider Details
I. General information
NPI: 1902105588
Provider Name (Legal Business Name): DAANISH KHALID SHAIKH M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 03/21/2011
Last Update Date: 09/23/2025
Certification Date: 09/23/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2451 E BASELINE RD STE 430
GILBERT AZ
85234-2473
US
IV. Provider business mailing address
8 CADILLAC DR STE 300
BRENTWOOD TN
37027-5337
US
V. Phone/Fax
- Phone: 602-313-4391
- Fax: 480-699-4427
- Phone: 615-425-0220
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207QA0401X |
| Taxonomy | Addiction Medicine (Family Medicine) Physician |
| License Number | 055269 |
| License Number State | CT |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207QA0401X |
| Taxonomy | Addiction Medicine (Family Medicine) Physician |
| License Number | 00293900 |
| License Number State | NY |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | 036136381 |
| License Number State | IL |
| # 4 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2083A0300X |
| Taxonomy | Addiction Medicine (Preventive Medicine) Physician |
| License Number | 75292 |
| License Number State | AZ |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2083A0300X |
| Taxonomy | Addiction Medicine (Preventive Medicine) Physician |
| License Number | 1019903 |
| License Number State | MA |
| # 6 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2083A0300X |
| Taxonomy | Addiction Medicine (Preventive Medicine) Physician |
| License Number | 64553-20 |
| License Number State | WI |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: