Provider Demographics
NPI:1558944611
Name:SHAIKH, ADAM BASHIR (DPT)
Entity Type:Individual
Prefix:
First Name:ADAM
Middle Name:BASHIR
Last Name:SHAIKH
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1535 BLOOMINGDALE DR
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48085-5096
Mailing Address - Country:US
Mailing Address - Phone:248-835-4563
Mailing Address - Fax:
Practice Address - Street 1:1555 SOUTH BLVD E
Practice Address - Street 2:
Practice Address - City:ROCHESTER HILLS
Practice Address - State:MI
Practice Address - Zip Code:48307-5605
Practice Address - Country:US
Practice Address - Phone:248-267-5600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-05
Last Update Date:2021-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501019991225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist