Provider Demographics
NPI:1811080310
Name:HAQUE, SHAHID N (MD)
Entity type:Individual
Prefix:DR
First Name:SHAHID
Middle Name:N
Last Name:HAQUE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:218 COMMONSWAY
Mailing Address - Street 2:BLDG B
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08755
Mailing Address - Country:US
Mailing Address - Phone:732-244-4448
Mailing Address - Fax:732-244-4818
Practice Address - Street 1:218 COMMONSWAY
Practice Address - Street 2:BLDG B
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08755
Practice Address - Country:US
Practice Address - Phone:732-244-4448
Practice Address - Fax:732-244-4818
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NJMA 0321792086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ22-2321871OtherTAX ID
NJC 54486Medicare UPIN