Provider Demographics
NPI:1427197755
Name:MIAN, SHAHID WAHEED (MD)
Entity Type:Individual
Prefix:DR
First Name:SHAHID
Middle Name:WAHEED
Last Name:MIAN
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 1:893 PARK AVE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10075-0368
Mailing Address - Country:US
Mailing Address - Phone:212-734-3344
Mailing Address - Fax:212-734-4037
Practice Address - Street 1:893 PARK AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-0304
Practice Address - Country:US
Practice Address - Phone:212-734-3344
Practice Address - Fax:212-734-4037
Is Sole Proprietor?:No
Enumeration Date:2007-02-05
Last Update Date:2022-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY157611207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY16D401Medicare ID - Type Unspecified
NYD91777Medicare UPIN