Provider Demographics
NPI:1245254911
Name:SHIEKH, HABIB U (MD)
Entity type:Individual
Prefix:
First Name:HABIB
Middle Name:U
Last Name:SHIEKH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2343 BROADWAY ST
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14212-2312
Mailing Address - Country:US
Mailing Address - Phone:716-839-9440
Mailing Address - Fax:716-839-5070
Practice Address - Street 1:2343 BROADWAY ST
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14212-2312
Practice Address - Country:US
Practice Address - Phone:716-839-9440
Practice Address - Fax:716-839-5070
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY130339207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00644257Medicaid
B36055Medicare UPIN
NY072363Medicare ID - Type Unspecified