Provider Demographics
NPI:1316024508
Name:HYDER, SHAKIR (MD)
Entity Type:Individual
Prefix:
First Name:SHAKIR
Middle Name:
Last Name:HYDER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2333 MOWRY AVE
Mailing Address - Street 2:STE 300
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94538-1626
Mailing Address - Country:US
Mailing Address - Phone:510-742-9242
Mailing Address - Fax:510-670-4772
Practice Address - Street 1:2333 MOWRY AVE
Practice Address - Street 2:SUITE 300
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94538
Practice Address - Country:US
Practice Address - Phone:510-796-0222
Practice Address - Fax:510-796-7760
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2017-07-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA42593207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AT758ZMedicare PIN