Provider Demographics
NPI:1245553098
Name:SHAIKH, QUDSIA (MD)
Entity type:Individual
Prefix:DR
First Name:QUDSIA
Middle Name:
Last Name:SHAIKH
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 1:275 E 200 S
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84111-2002
Mailing Address - Country:US
Mailing Address - Phone:800-366-1884
Mailing Address - Fax:
Practice Address - Street 1:6 SPRUCE ST
Practice Address - Street 2:
Practice Address - City:WEST READING
Practice Address - State:PA
Practice Address - Zip Code:19611-1454
Practice Address - Country:US
Practice Address - Phone:484-628-5455
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-09
Last Update Date:2023-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD447107207R00000X
NMMD2013-0051207R00000X
ORMD174931207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine