Provider Demographics
NPI:1679651103
Name:SAYEED, SHAIK O (MD)
Entity Type:Individual
Prefix:
First Name:SHAIK
Middle Name:O
Last Name:SAYEED
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:SHAIK
Other - Middle Name:OSMAN
Other - Last Name:SAYEED
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:100 - 15TH AVE.
Mailing Address - Street 2:STE 180
Mailing Address - City:SOUTH MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53172-1160
Mailing Address - Country:US
Mailing Address - Phone:414-768-5430
Mailing Address - Fax:414-762-4225
Practice Address - Street 1:5900 S. LAKE DR.
Practice Address - Street 2:LAKESHORE MEDICAL CLINIC
Practice Address - City:CUDAHY
Practice Address - State:WI
Practice Address - Zip Code:53110-3171
Practice Address - Country:US
Practice Address - Phone:414-489-4190
Practice Address - Fax:414-489-4015
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2021-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI466442084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI02120-0168Medicare PIN