Healthcare Provider Details

I. General information

NPI: 1396234001
Provider Name (Legal Business Name): BABAR SHAIKH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/08/2018
Last Update Date: 05/16/2024
Certification Date: 05/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3200 MACCORKLE AVE SE FL 5
CHARLESTON WV
25304-1297
US

IV. Provider business mailing address

400 ASSOCIATION DR
CHARLESTON WV
25311-1295
US

V. Phone/Fax

Practice location:
  • Phone: 304-388-1000
  • Fax:
Mailing address:
  • Phone: 304-388-0267
  • Fax: 304-388-1721

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number33195
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: