Provider Demographics
NPI:1609137009
Name:TALHA SHAMIM, MD LLC
Entity Type:Organization
Organization Name:TALHA SHAMIM, MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:TALHA
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAMIM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-972-9553
Mailing Address - Street 1:1426 MARBLE CREST WAY
Mailing Address - Street 2:
Mailing Address - City:WINTER GARDEN
Mailing Address - State:FL
Mailing Address - Zip Code:34787-4656
Mailing Address - Country:US
Mailing Address - Phone:877-445-9052
Mailing Address - Fax:877-530-1781
Practice Address - Street 1:1780 S BELLAIRE ST
Practice Address - Street 2:SUITE 230
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80222-4307
Practice Address - Country:US
Practice Address - Phone:877-445-9052
Practice Address - Fax:877-530-1781
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-01
Last Update Date:2012-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME102917174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty