Provider Demographics
NPI:1043211196
Name:SHAJIHAN, NASIM (MD)
Entity Type:Individual
Prefix:DR
First Name:NASIM
Middle Name:
Last Name:SHAJIHAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:NASIM
Other - Middle Name:
Other - Last Name:ABUBACKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:601 CHILDREN'S LANE
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23507
Mailing Address - Country:US
Mailing Address - Phone:757-668-7007
Mailing Address - Fax:
Practice Address - Street 1:601 CHILDREN'S LANE
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VI
Practice Address - Zip Code:23507-1723
Practice Address - Country:US
Practice Address - Phone:757-668-7000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-08-10
Last Update Date:2023-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01012754182084P0804X
PAMD4202442084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0101275418OtherLICENSE
PAMD420244OtherMED LIC NUMBER