Provider Demographics
NPI:1720186455
Name:SAEED, SHAMIM J (MD)
Entity Type:Individual
Prefix:
First Name:SHAMIM
Middle Name:J
Last Name:SAEED
Suffix:
Gender:F
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:PO BOX 8519
Mailing Address - Street 2:
Mailing Address - City:RED BANK
Mailing Address - State:NJ
Mailing Address - Zip Code:07701-8519
Mailing Address - Country:US
Mailing Address - Phone:732-460-9840
Mailing Address - Fax:732-460-9848
Practice Address - Street 1:30 SHREWSBURY PLZ
Practice Address - Street 2:
Practice Address - City:SHREWSBURY
Practice Address - State:NJ
Practice Address - Zip Code:07702-4322
Practice Address - Country:US
Practice Address - Phone:732-542-0002
Practice Address - Fax:732-542-2992
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2015-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07504400207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ9049100Medicaid
NJ9049100Medicaid
NJ065232Medicare ID - Type Unspecified
NJ114607OtherAMERIGOURP
NJH75582Medicare UPIN
NJ9049100Medicaid