Healthcare Provider Details

I. General information

NPI: 1275575581
Provider Name (Legal Business Name): SHOAIB SHEIKH M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/12/2006
Last Update Date: 06/05/2024
Certification Date: 06/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1105 E DIVISION ST
NEILLSVILLE WI
54456-2122
US

IV. Provider business mailing address

1105 E DIVISION ST
NEILLSVILLE WI
54456-2122
US

V. Phone/Fax

Practice location:
  • Phone: 715-819-1044
  • Fax:
Mailing address:
  • Phone: 715-819-1044
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number49204
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number15751
License Number StateND
# 3
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number01082211A
License Number StateIN
# 4
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number7369A
License Number StateWY
# 5
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number339848
License Number StateLA
# 6
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number01082211A
License Number StateIN
# 7
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number15751
License Number StateND

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: