Healthcare Provider Details

I. General information

NPI: 1609802644
Provider Name (Legal Business Name): NASIM AHMAD SHEIKH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4502 MACCORKLE AVE SW
SOUTH CHARLESTON WV
25309
US

IV. Provider business mailing address

4502 MACCORKLE AVE SW
SOUTH CHARLESTON WV
25309
US

V. Phone/Fax

Practice location:
  • Phone: 304-768-3500
  • Fax: 304-768-4010
Mailing address:
  • Phone: 304-768-3500
  • Fax: 304-768-4010

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RA0201X
TaxonomyAllergy & Immunology (Internal Medicine) Physician
License Number17952
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: