Provider Demographics
NPI:1033128244
Name:ADAM SHAIKH OD AND ASSOCIATES PC
Entity Type:Organization
Organization Name:ADAM SHAIKH OD AND ASSOCIATES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:WALLY
Authorized Official - Last Name:SHAIKH
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:404-468-8717
Mailing Address - Street 1:970 SIDNEY MARCUS BLVD
Mailing Address - Street 2:1417
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30324
Mailing Address - Country:US
Mailing Address - Phone:404-468-8717
Mailing Address - Fax:
Practice Address - Street 1:5600 NORTH HENRY BLVD
Practice Address - Street 2:VISION CENTER
Practice Address - City:STOCKBRIDGE
Practice Address - State:GA
Practice Address - Zip Code:30281
Practice Address - Country:US
Practice Address - Phone:770-507-9010
Practice Address - Fax:770-506-7504
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOPT002051152W00000X
ALSA39TA599152W00000X
OK2323152W00000X
TN223S152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
U81114Medicare UPIN