Provider Demographics
NPI:1639783798
Name:SHAIKH, AFTAB DEE (PA-C)
Entity Type:Individual
Prefix:
First Name:AFTAB
Middle Name:DEE
Last Name:SHAIKH
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:117 BENJAMINS CT
Mailing Address - Street 2:
Mailing Address - City:SEAFORD
Mailing Address - State:VA
Mailing Address - Zip Code:23696-2366
Mailing Address - Country:US
Mailing Address - Phone:757-969-2201
Mailing Address - Fax:
Practice Address - Street 1:3000 COLISEUM DR
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:VA
Practice Address - Zip Code:23666-5963
Practice Address - Country:US
Practice Address - Phone:757-736-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-04
Last Update Date:2020-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0110-007370363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant