Provider Demographics
NPI:1922079508
Name:CHEEMA, SHAHBAZ ALI (MD)
Entity Type:Individual
Prefix:MR
First Name:SHAHBAZ
Middle Name:ALI
Last Name:CHEEMA
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:10250 SE 167TH PLACE RD UNIT 5
Mailing Address - Street 2:
Mailing Address - City:SUMMERFIELD
Mailing Address - State:FL
Mailing Address - Zip Code:34491-8682
Mailing Address - Country:US
Mailing Address - Phone:352-307-9925
Mailing Address - Fax:352-307-8442
Practice Address - Street 1:10250 SE 167TH PLACE RD
Practice Address - Street 2:SUITE 5
Practice Address - City:SUMMERFIELD
Practice Address - State:FL
Practice Address - Zip Code:34491-8686
Practice Address - Country:US
Practice Address - Phone:352-307-9925
Practice Address - Fax:352-307-8442
Is Sole Proprietor?:No
Enumeration Date:2006-01-31
Last Update Date:2018-01-11
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME85893207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL265427000Medicaid