Provider Demographics
NPI:1669676250
Name:ABEDIN, SHAAD ESSA (MD FACP)
Entity Type:Individual
Prefix:DR
First Name:SHAAD
Middle Name:ESSA
Last Name:ABEDIN
Suffix:
Gender:M
Credentials:MD FACP
Other - Prefix:
Other - First Name:SHAAD
Other - Middle Name:ESSA
Other - Last Name:ABDULLAH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD FACP
Mailing Address - Street 1:6800 WISCONSIN AVE # 1125
Mailing Address - Street 2:
Mailing Address - City:CHEVY CHASE
Mailing Address - State:MD
Mailing Address - Zip Code:20815-6105
Mailing Address - Country:US
Mailing Address - Phone:240-200-4115
Mailing Address - Fax:646-349-7620
Practice Address - Street 1:6800 WISCONSIN AVE # 1125
Practice Address - Street 2:
Practice Address - City:CHEVY CHASE
Practice Address - State:MD
Practice Address - Zip Code:20815-6105
Practice Address - Country:US
Practice Address - Phone:240-200-4115
Practice Address - Fax:646-349-7620
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-14
Last Update Date:2023-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD041091207RH0003X
MDD0074899207RH0003X
VA0101252823207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
3853003503OtherMYUTMB 3853003503-COMMERCIAL NUMBER