Provider Demographics
NPI:1003918152
Name:SHAHEED, NAIM G (DPM)
Entity Type:Individual
Prefix:
First Name:NAIM
Middle Name:G
Last Name:SHAHEED
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1975 HIGHWAY 54 W STE 205
Mailing Address - Street 2:
Mailing Address - City:PEACHTREE CITY
Mailing Address - State:GA
Mailing Address - Zip Code:30269-4794
Mailing Address - Country:US
Mailing Address - Phone:678-902-0457
Mailing Address - Fax:770-415-1450
Practice Address - Street 1:6000 HILLANDALE DR STE 125
Practice Address - Street 2:
Practice Address - City:LITHONIA
Practice Address - State:GA
Practice Address - Zip Code:30058-4851
Practice Address - Country:US
Practice Address - Phone:770-981-9011
Practice Address - Fax:770-981-0480
Is Sole Proprietor?:No
Enumeration Date:2006-09-01
Last Update Date:2023-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPOD000637213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA48SCBNDOtherMEDICARE PROVIDER NUMBER
GAODD536313BMedicaid
GAODD536313BMedicaid
U18991Medicare UPIN