Provider Demographics
NPI:1538059910
Name:MESSIAH MEDICAL PLLC
Entity type:Organization
Organization Name:MESSIAH MEDICAL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SHADI
Authorized Official - Middle Name:
Authorized Official - Last Name:MESSIAH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:415-602-6781
Mailing Address - Street 1:9200 NW 39TH AVE
Mailing Address - Street 2:STE 130 #3401
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32606
Mailing Address - Country:US
Mailing Address - Phone:415-602-6781
Mailing Address - Fax:
Practice Address - Street 1:12269 SW SIXTH PLACE
Practice Address - Street 2:
Practice Address - City:NEWBERRY
Practice Address - State:FL
Practice Address - Zip Code:32669
Practice Address - Country:US
Practice Address - Phone:415-602-6781
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-07
Last Update Date:2025-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes202D00000XAllopathic & Osteopathic PhysiciansIntegrative MedicineGroup - Multi-Specialty