Provider Demographics
NPI:1609879170
Name:SHAIKH, ANWER ALAM (MD)
Entity Type:Individual
Prefix:DR
First Name:ANWER
Middle Name:ALAM
Last Name:SHAIKH
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 1:6323 N FRESNO ST STE 105
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93710-5282
Mailing Address - Country:US
Mailing Address - Phone:559-431-0995
Mailing Address - Fax:559-431-0998
Practice Address - Street 1:6323 N FRESNO ST STE 105
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93710-5282
Practice Address - Country:US
Practice Address - Phone:559-431-0995
Practice Address - Fax:559-431-0998
Is Sole Proprietor?:Yes
Enumeration Date:2005-05-27
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIA80989174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAB55785449OtherDEA #
CAG99617Medicare UPIN
CA00A809890Medicare ID - Type Unspecified