Provider Demographics
NPI:1437205796
Name:SHEIKH, MOHAMMAD TAYYAB
Entity Type:Individual
Prefix:DR
First Name:MOHAMMAD
Middle Name:TAYYAB
Last Name:SHEIKH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1168 N STATE ROAD 7
Mailing Address - Street 2:
Mailing Address - City:LAUDERHILL
Mailing Address - State:FL
Mailing Address - Zip Code:33313-6630
Mailing Address - Country:US
Mailing Address - Phone:954-581-7700
Mailing Address - Fax:954-581-7090
Practice Address - Street 1:1168 N STATE ROAD 7
Practice Address - Street 2:
Practice Address - City:LAUDERHILL
Practice Address - State:FL
Practice Address - Zip Code:33313-6630
Practice Address - Country:US
Practice Address - Phone:954-581-7700
Practice Address - Fax:954-581-7090
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-26
Last Update Date:2018-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME86678208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL266715100Medicaid
FLU1612DMedicare ID - Type Unspecified
FL266715100Medicaid