Provider Demographics
NPI:1518206622
Name:WIQAR U SHEIKH MD PA
Entity Type:Organization
Organization Name:WIQAR U SHEIKH MD PA
Other - Org Name:SOUTHGATE MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:WIQAR
Authorized Official - Middle Name:
Authorized Official - Last Name:SHEIKH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:954-721-8707
Mailing Address - Street 1:7326 SOUTHGATE BLVD
Mailing Address - Street 2:
Mailing Address - City:N LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33068-1427
Mailing Address - Country:US
Mailing Address - Phone:954-721-8707
Mailing Address - Fax:
Practice Address - Street 1:7326 SOUTHGATE BLVD
Practice Address - Street 2:
Practice Address - City:N LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33068-1427
Practice Address - Country:US
Practice Address - Phone:954-721-8707
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-08
Last Update Date:2013-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME79299207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL265564100Medicaid
FL265564100Medicaid