Healthcare Provider Details

I. General information

NPI: 1306374632
Provider Name (Legal Business Name): SAQIB JAWED SHAMI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/31/2017
Last Update Date: 09/11/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3838 N CAMPBELL AVE
TUCSON AZ
85719-1454
US

IV. Provider business mailing address

315 ELMRIDGE CT
RIVERSIDE CA
92506-6293
US

V. Phone/Fax

Practice location:
  • Phone: 520-694-8888
  • Fax: 520-505-2476
Mailing address:
  • Phone: 951-376-9001
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License NumberR80684
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number125070178
License Number StateIL
# 3
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA207330
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: