Provider Demographics
NPI:1952072555
Name:AKTHER, SHAJEEN UDDIN (MSPAS)
Entity type:Individual
Prefix:
First Name:SHAJEEN
Middle Name:UDDIN
Last Name:AKTHER
Suffix:
Gender:
Credentials:MSPAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:151 SOUTHHALL LN STE 300
Mailing Address - Street 2:
Mailing Address - City:MAITLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32751-7172
Mailing Address - Country:US
Mailing Address - Phone:239-465-4916
Mailing Address - Fax:
Practice Address - Street 1:1838 GREENE TREE RD STE 340
Practice Address - Street 2:
Practice Address - City:PIKESVILLE
Practice Address - State:MD
Practice Address - Zip Code:21208-7116
Practice Address - Country:US
Practice Address - Phone:410-602-3376
Practice Address - Fax:410-602-7954
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-23
Last Update Date:2025-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDC0008220363AM0700X
MD363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical