Healthcare Provider Details
I. General information
NPI: 1730927039
Provider Name (Legal Business Name): SHAHDAD K SAEEDI DPM PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/19/2024
Last Update Date: 02/06/2025
Certification Date: 02/06/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2440 W HORIZON RIDGE PKWY STE 130
HENDERSON NV
89052-2731
US
IV. Provider business mailing address
2440 W HORIZON RIDGE PKWY STE 130
HENDERSON NV
89052-2731
US
V. Phone/Fax
- Phone: 702-553-3388
- Fax:
- Phone: 702-553-3388
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 213E00000X |
| Taxonomy | Podiatrist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
SHAHDAD
K
SAEEDI
Title or Position: PHYSICIAN
Credential: DPM, FACPM
Phone: 702-553-3338