Provider Demographics
NPI:1154443208
Name:YOUSAF, SHAHEER (MD FACS,FAAOS)
Entity Type:Individual
Prefix:DR
First Name:SHAHEER
Middle Name:
Last Name:YOUSAF
Suffix:
Gender:M
Credentials:MD FACS,FAAOS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 POST OFFICE RD
Mailing Address - Street 2:SUITE Y
Mailing Address - City:WALDORF
Mailing Address - State:MD
Mailing Address - Zip Code:20602-2744
Mailing Address - Country:US
Mailing Address - Phone:301-645-5410
Mailing Address - Fax:301-645-7680
Practice Address - Street 1:7 POST OFFICE RD
Practice Address - Street 2:SUITE Y
Practice Address - City:WALDORF
Practice Address - State:MD
Practice Address - Zip Code:20602-2744
Practice Address - Country:US
Practice Address - Phone:301-645-5410
Practice Address - Fax:301-645-7680
Is Sole Proprietor?:No
Enumeration Date:2007-04-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0027167174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDD01352Medicare UPIN