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NPI Code Detail

MEDICARE: DR. SAMUEL THEODORE SHAIKEWITZ MD

MEDICARE: DR. SAMUEL THEODORE SHAIKEWITZ 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
1207RN0300XNephrology Physician9801487NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1447276381
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SAMUEL THEODORE SHAIKEWITZ MD
Provider Business Mailing Address
First Line : 4419 BEN FRANKLIN BLVD
Second Line :
City : DURHAM
State : NC
Zip : 27704-2147
Country : US
Telephone Number : 919-477-3005
Fax Number : 919-477-5526
Provider Business Practice Location Address
First Line : 4419 BEN FRANKLIN BLVD
Second Line :
City : DURHAM
State : NC
Zip : 27704-2147
Country : US
Telephone Number : 919-477-3005
Fax Number : 919-477-5526
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/14/2006
Last Update Date : 02/01/2022

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