MEDICARE: DR. NASIM SHAJIHAN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0804X	Child & Adolescent Psychiatry Physician	0101275418	VA
2	2084P0800X	Psychiatry Physician	MD420244	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0101275418	OTHER	VA	LICENSE
2	MD420244	OTHER	PA	MED LIC NUMBER

General Provider Information

NPI Number	:	1043211196
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NASIM SHAJIHAN MD

Provider Business Mailing Address
First Line	:	601 CHILDREN'S LANE
Second Line	:
City	:	NORFOLK
State	:	VA
Zip	:	23507
Country	:	US
Telephone Number	:	757-668-7007
Fax Number	:

Provider Business Practice Location Address
First Line	:	601 CHILDREN'S LANE
Second Line	:
City	:	NORFOLK
State	:	VI
Zip	:	23507-1723
Country	:	US
Telephone Number	:	757-668-7000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/10/2005
Last Update Date	:	06/14/2023

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