Provider Demographics
NPI:1245684166
Name:SAEEDI, SHAHDAD K (DPM)
Entity type:Individual
Prefix:DR
First Name:SHAHDAD
Middle Name:K
Last Name:SAEEDI
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2440 W HORIZON RIDGE PKWY STE 130
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89052-2731
Mailing Address - Country:US
Mailing Address - Phone:702-553-3338
Mailing Address - Fax:702-725-2538
Practice Address - Street 1:2440 W HORIZON RIDGE PKWY STE 130
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89052-2731
Practice Address - Country:US
Practice Address - Phone:702-553-3338
Practice Address - Fax:702-725-2538
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-18
Last Update Date:2024-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE5561213ES0000X
NV2076213ES0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0000XPodiatric Medicine & Surgery Service ProvidersPodiatristSports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
14621811OtherCAQH