Provider Demographics
NPI:1912969130
Name:SHAIKH, ALI AKHTER (MD)
Entity Type:Individual
Prefix:DR
First Name:ALI
Middle Name:AKHTER
Last Name:SHAIKH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2929 WATSON BLVD STE 2
Mailing Address - Street 2:PMB 125
Mailing Address - City:WARNER ROBINS
Mailing Address - State:GA
Mailing Address - Zip Code:31093-9601
Mailing Address - Country:US
Mailing Address - Phone:478-333-3603
Mailing Address - Fax:478-333-3685
Practice Address - Street 1:1601 WATSON BLVD
Practice Address - Street 2:HOUSTON MEDICAL CENTER, ATTN: RADIOLOGY DEPT
Practice Address - City:WARNER ROBINS
Practice Address - State:GA
Practice Address - Zip Code:31093-3431
Practice Address - Country:US
Practice Address - Phone:478-333-3603
Practice Address - Fax:478-333-3685
Is Sole Proprietor?:No
Enumeration Date:2006-04-04
Last Update Date:2016-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0563632085R0202X, 2085N0700X, 2085R0204X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No2085N0700XAllopathic & Osteopathic PhysiciansRadiologyNeuroradiology
No2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAP00346867OtherRAILROAD MEDICARE
GA52185752006OtherBCBS-PERRY
GA738783668CMedicaid
GA738783668BMedicaid
GA52185752002OtherBCBS-WARNER ROBINS
GA30BDNBRMedicare PIN
H86220Medicare UPIN
AZ31673OtherAZ MEDICAL LICENSE#
GA56363OtherGA MEDICAL LICENSE#
GA30BDNBRMedicare PIN
AL31673OtherAL MEDICAL LICENSE#
H86220Medicare UPIN