Provider Demographics
NPI: | 1821431636 |
---|---|
Name: | SHAIKH, SAMEED S (DO) |
Entity Type: | Individual |
Prefix: | |
First Name: | SAMEED |
Middle Name: | S |
Last Name: | SHAIKH |
Suffix: | |
Gender: | M |
Credentials: | DO |
Other - Prefix: | |
Other - First Name: | SAMEED |
Other - Middle Name: | SATTAR |
Other - Last Name: | SHAIKH |
Other - Suffix: | |
Other - Last Name Type: | Professional Name |
Other - Credentials: | DO |
Mailing Address - Street 1: | 3288 MOANALUA RD |
Mailing Address - Street 2: | |
Mailing Address - City: | HONOLULU |
Mailing Address - State: | HI |
Mailing Address - Zip Code: | 96819-1469 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 808-432-0000 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 3288 MOANALUA RD |
Practice Address - Street 2: | |
Practice Address - City: | HONOLULU |
Practice Address - State: | HI |
Practice Address - Zip Code: | 96819-1469 |
Practice Address - Country: | US |
Practice Address - Phone: | 808-432-0000 |
Practice Address - Fax: | |
Is Sole Proprietor?: | No |
Enumeration Date: | 2013-04-10 |
Last Update Date: | 2023-08-23 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
CO | DR.0056995 | 207P00000X |
390200000X | ||
HI | DOS-2277 | 207P00000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 207P00000X | Allopathic & Osteopathic Physicians | Emergency Medicine | |
No | 390200000X | Student, Health Care | Student in an Organized Health Care Education/Training Program |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
CO | DR.0056995 | Other | COLORADO MEDICAL LICENSE |