Provider Demographics
NPI:1609990779
Name:SHAIKH, FAREED RAZA (MD)
Entity Type:Individual
Prefix:
First Name:FAREED
Middle Name:RAZA
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 1:477 COOPER RD STE 200
Mailing Address - Street 2:
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43081-8054
Mailing Address - Country:US
Mailing Address - Phone:146-627-2000
Mailing Address - Fax:
Practice Address - Street 1:477 COOPER RD STE 200
Practice Address - Street 2:
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43081-8054
Practice Address - Country:US
Practice Address - Phone:614-627-2000
Practice Address - Fax:614-552-0206
Is Sole Proprietor?:No
Enumeration Date:2007-03-16
Last Update Date:2021-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35092086207RI0011X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2836793Medicaid
INM400066102Medicare PIN
OHSH4241417Medicare PIN
OH2836793Medicaid
OHSH4241418Medicare PIN