Provider Demographics
NPI:1396125647
Name:SHMAISANI, ZAID MOHAMMED-KHAIR (MD)
Entity type:Individual
Prefix:MR
First Name:ZAID
Middle Name:MOHAMMED-KHAIR
Last Name:SHMAISANI
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 1:2518 JIMMY LEE SMITH PKWY
Mailing Address - Street 2:
Mailing Address - City:HIRAM
Mailing Address - State:GA
Mailing Address - Zip Code:30141-2068
Mailing Address - Country:US
Mailing Address - Phone:470-644-8027
Mailing Address - Fax:470-986-7105
Practice Address - Street 1:2518 JIMMY LEE SMITH PKWY
Practice Address - Street 2:
Practice Address - City:HIRAM
Practice Address - State:GA
Practice Address - Zip Code:30141-2068
Practice Address - Country:US
Practice Address - Phone:470-644-8027
Practice Address - Fax:470-986-7105
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-02
Last Update Date:2024-09-26
Deactivation Date:2016-01-20
Deactivation Code:
Reactivation Date:2016-04-13
Provider Licenses
StateLicense IDTaxonomies
MO2015019929207R00000X
GA93784208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine