Provider Demographics
NPI:1235173170
Name:SHEIKH, MANSOOR (MD)
Entity Type:Individual
Prefix:DR
First Name:MANSOOR
Middle Name:
Last Name:SHEIKH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:MANSOOR
Other - Middle Name:
Other - Last Name:SHEIKH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:66D RIVER BEND RD
Mailing Address - Street 2:
Mailing Address - City:STRATFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06614-8017
Mailing Address - Country:US
Mailing Address - Phone:203-612-8747
Mailing Address - Fax:203-612-8747
Practice Address - Street 1:66D RIVER BEND RD
Practice Address - Street 2:
Practice Address - City:STRATFORD
Practice Address - State:CT
Practice Address - Zip Code:06614-8017
Practice Address - Country:US
Practice Address - Phone:480-619-3061
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-15
Last Update Date:2020-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT37224207R00000X
KY34644207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty