Healthcare Provider Details

I. General information

NPI: 1992799829
Provider Name (Legal Business Name): ABDUL M SHEIKH M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/07/2005
Last Update Date: 09/22/2021
Certification Date: 09/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

114 WOODLAND ST DEPT. OF MEDICINE
HARTFORD CT
06105-1208
US

IV. Provider business mailing address

114 WOODLAND ST DEPT. OF MEDICINE
HARTFORD CT
06105-1208
US

V. Phone/Fax

Practice location:
  • Phone: 860-714-7446
  • Fax: 860-714-1508
Mailing address:
  • Phone: 860-714-7446
  • Fax: 860-714-1508

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number044671
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberMD203948
License Number StateLA
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number044671
License Number StateCT
# 4
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number044671
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: