Provider Demographics
NPI:1851433320
Name:NAIM G. SHAHEED, DPM, P.C.
Entity Type:Organization
Organization Name:NAIM G. SHAHEED, DPM, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:NAIM
Authorized Official - Middle Name:G
Authorized Official - Last Name:SHAHEED
Authorized Official - Suffix:
Authorized Official - Credentials:DPM, PC
Authorized Official - Phone:770-981-9011
Mailing Address - Street 1:5910 HILLANDALE DRIVE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:LITHONIA
Mailing Address - State:GA
Mailing Address - Zip Code:30058-1877
Mailing Address - Country:US
Mailing Address - Phone:770-981-9011
Mailing Address - Fax:770-981-0480
Practice Address - Street 1:5910 HILLANDALE DRIVE
Practice Address - Street 2:SUITE 102
Practice Address - City:LITHONIA
Practice Address - State:GA
Practice Address - Zip Code:30058-1877
Practice Address - Country:US
Practice Address - Phone:770-981-9011
Practice Address - Fax:770-981-0480
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-13
Last Update Date:2011-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
213ES0103X
GA000637213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot SurgeryGroup - Multi-Specialty
No213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000536313BMedicaid
3900790001Medicare NSC
1851433320Medicare PIN
GA48SCBNDMedicare UPIN