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General NPI Number Information
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NPI Number | 1891511887
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Entity Type | Organization
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Legal Business Name | SHAIK ABDUL MD LLC
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Dates
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Enumeration Date | 11/25/2024
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Last Update Date | 11/25/2024
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Provider Practice Location Address
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Address Line | 220 TILGHMAN RD
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City | SALISBURY
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State | MD
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Zip | 21804-1921
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Country | US
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Telephone | 469-469-8365
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Fax |
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Provider Business Mailing Address
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Address Line | 3659 ROSANAH ST
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City | FRISCO
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State | TX
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Zip | 75033-1738
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Country | US
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Telephone | 469-469-8365
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Fax |
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL
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Name | SAMEER-TAJUDDEN SHAIK-ABDUL
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Credential | MD
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Telephone | 469-469-8365
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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