Provider Demographics
NPI:1386832921
Name:SHOAIB NEUROLOGICAL SERVICES
Entity Type:Organization
Organization Name:SHOAIB NEUROLOGICAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MUHAMMAD
Authorized Official - Middle Name:ASIM
Authorized Official - Last Name:SHOAIB
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:270-737-7021
Mailing Address - Street 1:2521 GLENN HENDREN DR STE 411
Mailing Address - Street 2:
Mailing Address - City:LIBERTY
Mailing Address - State:MO
Mailing Address - Zip Code:64068-3388
Mailing Address - Country:US
Mailing Address - Phone:816-407-9232
Mailing Address - Fax:816-407-9239
Practice Address - Street 1:2521 GLENN HENDREN DR STE 411
Practice Address - Street 2:
Practice Address - City:LIBERTY
Practice Address - State:MO
Practice Address - Zip Code:64068-3388
Practice Address - Country:US
Practice Address - Phone:816-407-9232
Practice Address - Fax:816-407-9239
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-09
Last Update Date:2023-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY402822084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY1363807Medicare PIN