Provider Demographics
NPI:1790105443
Name:SHAKEEL, SHOAIB (DO)
Entity Type:Individual
Prefix:MR
First Name:SHOAIB
Middle Name:
Last Name:SHAKEEL
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 TAYLOR STATION RD STE 200
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43213-4470
Mailing Address - Country:US
Mailing Address - Phone:614-627-1300
Mailing Address - Fax:
Practice Address - Street 1:150 TAYLOR STATION RD STE 200
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43213-4470
Practice Address - Country:US
Practice Address - Phone:614-627-1300
Practice Address - Fax:614-627-1304
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-21
Last Update Date:2020-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5051010019207RP1001X, 207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine