Provider Demographics
NPI:1700226537
Name:CHEEMA, CHAUDHRY SHAHZAD ALI (MD)
Entity Type:Individual
Prefix:
First Name:CHAUDHRY SHAHZAD
Middle Name:ALI
Last Name:CHEEMA
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 1:16400 S HIGHWAY 25
Mailing Address - Street 2:
Mailing Address - City:WEIRSDALE
Mailing Address - State:FL
Mailing Address - Zip Code:32195-2442
Mailing Address - Country:US
Mailing Address - Phone:352-821-9797
Mailing Address - Fax:352-821-0553
Practice Address - Street 1:16400 S HIGHWAY 25
Practice Address - Street 2:
Practice Address - City:WEIRSDALE
Practice Address - State:FL
Practice Address - Zip Code:32195-2442
Practice Address - Country:US
Practice Address - Phone:352-821-9797
Practice Address - Fax:352-821-0553
Is Sole Proprietor?:No
Enumeration Date:2013-06-25
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME127526207R00000X
ZZ390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program