Provider Demographics
NPI:1063440865
Name:SHAIKH, BASHIR U (MD)
Entity type:Individual
Prefix:DR
First Name:BASHIR
Middle Name:U
Last Name:SHAIKH
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 1:1608 SE 3RD AVE
Mailing Address - Street 2:THIRD FLOOR PBO
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33316-2564
Mailing Address - Country:US
Mailing Address - Phone:954-786-5902
Mailing Address - Fax:954-786-0129
Practice Address - Street 1:2011 NW 3RD AVE
Practice Address - Street 2:
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33060-4800
Practice Address - Country:US
Practice Address - Phone:954-786-5902
Practice Address - Fax:954-786-0129
Is Sole Proprietor?:No
Enumeration Date:2006-06-29
Last Update Date:2016-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 65557207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL110222332OtherRAILROAD MEDICARE
FL25462WMedicare ID - Type UnspecifiedMEDICARE PROVIDER #