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General NPI Number Information
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NPI Number | 1245684166
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Entity Type | Individual
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Provider Name | SHAHDAD K SAEEDI DPM
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Gender | Male
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Dates
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Enumeration Date | 04/18/2016
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Last Update Date | 08/02/2024
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Provider Practice Location Address
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Address Line | 2440 W HORIZON RIDGE PKWY STE 130
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City | HENDERSON
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State | NV
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Zip | 89052-2731
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Country | US
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Telephone | 702-553-3338
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Fax | 702-725-2538
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Provider Business Mailing Address
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Address Line | 2440 W HORIZON RIDGE PKWY STE 130
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City | HENDERSON
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State | NV
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Zip | 89052-2731
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Country | US
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Telephone | 702-553-3338
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Fax | 702-725-2538
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0000X
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Taxonomy Name | Sports Medicine Podiatrist
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License Number | E5561
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 213ES0000X
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Taxonomy Name | Sports Medicine Podiatrist
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License Number | 2076
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License Number State | NV
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