Provider Demographics
NPI:1982673661
Name:SHAIKH, AYAZ (MD)
Entity Type:Individual
Prefix:DR
First Name:AYAZ
Middle Name:
Last Name:SHAIKH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:AYAZ
Other - Middle Name:
Other - Last Name:SHEIKH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 1510
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47706-1510
Mailing Address - Country:US
Mailing Address - Phone:812-426-9235
Mailing Address - Fax:812-490-4512
Practice Address - Street 1:4233 GATEWAY BLVD
Practice Address - Street 2:
Practice Address - City:NEWBURGH
Practice Address - State:IN
Practice Address - Zip Code:47630-8900
Practice Address - Country:US
Practice Address - Phone:812-426-9235
Practice Address - Fax:812-490-4512
Is Sole Proprietor?:No
Enumeration Date:2006-03-16
Last Update Date:2018-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH85893208200000X
IL0361162422086S0122X
IN01065635A2086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
No208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000585313OtherANTHEM PROVIDER NUMBER
IN200916480Medicaid
IN815460A2Medicare PIN
IN815500N8Medicare PIN
IN000000585313OtherANTHEM PROVIDER NUMBER
IN200916480Medicaid