Provider Demographics
NPI:1891189072
Name:SHABBIR, SHAHID
Entity Type:Individual
Prefix:
First Name:SHAHID
Middle Name:
Last Name:SHABBIR
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4134 43RD ST
Mailing Address - Street 2:APT B3
Mailing Address - City:SUNNYSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11104-2580
Mailing Address - Country:US
Mailing Address - Phone:917-721-1493
Mailing Address - Fax:
Practice Address - Street 1:15 E AUDUBON DR
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93720-1542
Practice Address - Country:US
Practice Address - Phone:559-433-8000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-25
Last Update Date:2021-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
282N00000X
CAA146864208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No282N00000XHospitalsGeneral Acute Care Hospital