Provider Demographics
NPI:1124512629
Name:SHAHZAD, SHEIKH RAZA (MBBS, MD)
Entity type:Individual
Prefix:
First Name:SHEIKH RAZA
Middle Name:
Last Name:SHAHZAD
Suffix:
Gender:M
Credentials:MBBS, MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1080 NEW CREEK HWY STE 1
Mailing Address - Street 2:
Mailing Address - City:KEYSER
Mailing Address - State:WV
Mailing Address - Zip Code:26726-9508
Mailing Address - Country:US
Mailing Address - Phone:304-788-5057
Mailing Address - Fax:304-788-5059
Practice Address - Street 1:1080 NEW CREEK HWY STE 1
Practice Address - Street 2:
Practice Address - City:KEYSER
Practice Address - State:WV
Practice Address - Zip Code:26726-9508
Practice Address - Country:US
Practice Address - Phone:304-788-5057
Practice Address - Fax:304-788-5059
Is Sole Proprietor?:No
Enumeration Date:2018-06-18
Last Update Date:2023-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV31836207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine