Provider Demographics
NPI:1457353690
Name:ABDULLAH, SHEIKH AHMED (MD)
Entity Type:Individual
Prefix:DR
First Name:SHEIKH
Middle Name:AHMED
Last Name:ABDULLAH
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 1:3280 20TH ST S
Mailing Address - Street 2:
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58104-5917
Mailing Address - Country:US
Mailing Address - Phone:701-293-7408
Mailing Address - Fax:701-235-2099
Practice Address - Street 1:6450 38TH AVE N STE 440
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33710-1653
Practice Address - Country:US
Practice Address - Phone:737-551-2033
Practice Address - Fax:631-591-6301
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-01
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD4052208200000X
FLME121389208200000X
MN37847208200000X
ND6638208200000X
261QM2500X
CAG130233208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty
No261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical SpecialtyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND17671Medicaid
MN03T85ABOtherMN BLUE SHIELD
ND117306OtherUCARE
ND1311082OtherMEDICA
MN577218400Medicaid
MN577218400Medicaid
NDBA3738424OtherDEA
NDF64824Medicare UPIN