Provider Demographics
NPI:1598516320
Name:SHAHZED, S M IRAM (MD)
Entity Type:Individual
Prefix:
First Name:S M IRAM
Middle Name:
Last Name:SHAHZED
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:936 WOODYCREST AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10452-5503
Mailing Address - Country:US
Mailing Address - Phone:718-414-1750
Mailing Address - Fax:
Practice Address - Street 1:936 WOODYCREST AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10452-5503
Practice Address - Country:US
Practice Address - Phone:718-414-1750
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-29
Last Update Date:2024-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP125485207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine