Healthcare Provider Details

I. General information

NPI: 1447224787
Provider Name (Legal Business Name): SHOAB A SAYEED DO
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 02/14/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

974 73RD ST SUITE 33
WINDSOR HEIGHTS IA
50312-1024
US

IV. Provider business mailing address

974 73RD ST SUITE 33
WINDSOR HEIGHTS IA
50312-1024
US

V. Phone/Fax

Practice location:
  • Phone: 515-223-4146
  • Fax: 515-223-1172
Mailing address:
  • Phone: 515-223-4146
  • Fax: 515-223-1172

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number02771
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: