Provider Demographics
NPI:1093946873
Name:SHOAB, SUAIMAN SYED (MD)
Entity Type:Individual
Prefix:DR
First Name:SUAIMAN
Middle Name:SYED
Last Name:SHOAB
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27
Mailing Address - Street 2:BRYN ADDA
Mailing Address - City:BANGOR
Mailing Address - State:GWYNEDD
Mailing Address - Zip Code:LL57 2LJ
Mailing Address - Country:GB
Mailing Address - Phone:0124-836-1669
Mailing Address - Fax:
Practice Address - Street 1:3655 VISTA AVE
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63110-2539
Practice Address - Country:US
Practice Address - Phone:314-577-6027
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-28
Last Update Date:2009-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20090218712086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery