Provider Demographics
NPI:1356631287
Name:SHAMEEM, RAJI M (MD)
Entity Type:Individual
Prefix:
First Name:RAJI
Middle Name:M
Last Name:SHAMEEM
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 1:7472 DOCS GROVE CIR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32819-8010
Mailing Address - Country:US
Mailing Address - Phone:407-241-1037
Mailing Address - Fax:321-842-7966
Practice Address - Street 1:7472 DOCS GROVE CIR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32819-8010
Practice Address - Country:US
Practice Address - Phone:407-241-1037
Practice Address - Fax:321-842-7966
Is Sole Proprietor?:No
Enumeration Date:2011-04-12
Last Update Date:2023-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME131216207RH0000X, 207RX0202X
PAFS2720680207RX0202X
PAMD453183207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
No207RH0000XAllopathic & Osteopathic PhysiciansInternal MedicineHematology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL2AWM1OtherFLORIDA BLUE
FL021046600Medicaid
FLIZ944ZOtherMEDICARE