Provider Demographics
NPI:1477838159
Name:BASHIR U SHAIKH MD PA
Entity Type:Organization
Organization Name:BASHIR U SHAIKH MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BASHIR
Authorized Official - Middle Name:U
Authorized Official - Last Name:SHAIKH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-439-8858
Mailing Address - Street 1:3918 VIA POINCIANA
Mailing Address - Street 2:SUITE 10
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33467-2991
Mailing Address - Country:US
Mailing Address - Phone:561-439-8858
Mailing Address - Fax:561-439-6851
Practice Address - Street 1:3918 VIA POINCIANA
Practice Address - Street 2:SUITE 10
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33467-2991
Practice Address - Country:US
Practice Address - Phone:561-439-8858
Practice Address - Fax:561-439-6851
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-13
Last Update Date:2011-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 65557261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center