Provider Demographics
NPI:1710106786
Name:NASEEM A SHEKHANI MD PC
Entity Type:Organization
Organization Name:NASEEM A SHEKHANI MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NASEEM
Authorized Official - Middle Name:A
Authorized Official - Last Name:SHEKHANI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:314-335-5140
Mailing Address - Street 1:2821 N BALLAS RD STE C64
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63131-2387
Mailing Address - Country:US
Mailing Address - Phone:314-733-5140
Mailing Address - Fax:314-965-7900
Practice Address - Street 1:2821 N BALLAS RD STE C64
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63131-2387
Practice Address - Country:US
Practice Address - Phone:314-733-5140
Practice Address - Fax:314-965-7900
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-25
Last Update Date:2021-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOMD101820208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
E81721Medicare UPIN