Provider Demographics
NPI:1649278870
Name:SHEKHANI, SHAHID (MD)
Entity type:Individual
Prefix:
First Name:SHAHID
Middle Name:
Last Name:SHEKHANI
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 1:1000 MINERAL POINT AVE
Mailing Address - Street 2:
Mailing Address - City:JANESVILLE
Mailing Address - State:WI
Mailing Address - Zip Code:53548-2940
Mailing Address - Country:US
Mailing Address - Phone:608-756-6871
Mailing Address - Fax:608-756-6501
Practice Address - Street 1:1000 MINERAL POINT AVE
Practice Address - Street 2:
Practice Address - City:JANESVILLE
Practice Address - State:WI
Practice Address - Zip Code:53548-2940
Practice Address - Country:US
Practice Address - Phone:608-756-6871
Practice Address - Fax:608-756-6501
Is Sole Proprietor?:No
Enumeration Date:2005-07-12
Last Update Date:2020-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301064127207RX0202X
WI44136-20207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000517515OtherANTHEM BCBS
MI4331600Medicaid
MI110270056OtherBCBS
IN200851920Medicaid
WI34341200Medicaid
WISHEKHSAOtherMERCYCARE INSURANCE
MIP00277426OtherRAILROAD MEDICARE
WIP00657878CD3624OtherRR MEDICARE
IN000000517515OtherANTHEM BCBS
IN200851920Medicaid
WI541760591Medicare PIN
WIP00657878CD3624OtherRR MEDICARE
IN898190M3Medicare PIN
WI34341200Medicaid