Provider Demographics
NPI:1497806269
Name:SHAIK, UMAI (MD)
Entity Type:Individual
Prefix:DR
First Name:UMAI
Middle Name:
Last Name:SHAIK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:UMAI
Other - Middle Name:
Other - Last Name:HABIBA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:48 TUNNEL RD
Mailing Address - Street 2:SUITE 203
Mailing Address - City:POTTSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17901-3875
Mailing Address - Country:US
Mailing Address - Phone:570-622-5455
Mailing Address - Fax:570-622-5493
Practice Address - Street 1:1851 WEST END AVE
Practice Address - Street 2:
Practice Address - City:POTTSVILLE
Practice Address - State:PA
Practice Address - Zip Code:17901-3875
Practice Address - Country:US
Practice Address - Phone:570-624-7337
Practice Address - Fax:570-624-1782
Is Sole Proprietor?:No
Enumeration Date:2007-01-16
Last Update Date:2010-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD058950L208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA01626111Medicaid