Provider Demographics
NPI:1760798268
Name:SHAIKH, IMRAN ABDUL SALAM (MD)
Entity Type:Individual
Prefix:DR
First Name:IMRAN
Middle Name:ABDUL SALAM
Last Name:SHAIKH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9823 SAGO POINT DR
Mailing Address - Street 2:
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33777-4905
Mailing Address - Country:US
Mailing Address - Phone:727-345-0160
Mailing Address - Fax:727-345-0100
Practice Address - Street 1:218 PASADENA AVE S
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33707-1251
Practice Address - Country:US
Practice Address - Phone:727-345-0160
Practice Address - Fax:727-345-0100
Is Sole Proprietor?:No
Enumeration Date:2010-08-23
Last Update Date:2022-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME114904207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL009484500Medicaid
FL009484500Medicaid