Provider Demographics
NPI:1932321809
Name:MOHSIN, SHEHNAZ (MD)
Entity Type:Individual
Prefix:
First Name:SHEHNAZ
Middle Name:
Last Name:MOHSIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6901 N 72ND ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68122-1709
Mailing Address - Country:US
Mailing Address - Phone:855-524-4001
Mailing Address - Fax:402-572-3206
Practice Address - Street 1:6901 N 72ND ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68122-1709
Practice Address - Country:US
Practice Address - Phone:855-524-4001
Practice Address - Fax:402-572-3206
Is Sole Proprietor?:No
Enumeration Date:2007-05-02
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE27961207Q00000X, 208M00000X
KY41366207Q00000X
IAMD44267208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY0380229Medicare PIN
KY0380128Medicare PIN
KY1451838Medicare PIN