Provider Demographics
NPI:1396704706
Name:SHAIKH, NAOMI N (MD)
Entity type:Individual
Prefix:
First Name:NAOMI
Middle Name:N
Last Name:SHAIKH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1405 MADISON PARK DR
Mailing Address - Street 2:SUITE 1
Mailing Address - City:GLEN BURNIE
Mailing Address - State:MD
Mailing Address - Zip Code:21061-5627
Mailing Address - Country:US
Mailing Address - Phone:410-582-9434
Mailing Address - Fax:410-582-9436
Practice Address - Street 1:1405 MADISON PARK DR
Practice Address - Street 2:SUITE 1
Practice Address - City:GLEN BURNIE
Practice Address - State:MD
Practice Address - Zip Code:21061-5627
Practice Address - Country:US
Practice Address - Phone:410-582-9434
Practice Address - Fax:410-582-9436
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-23
Last Update Date:2017-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0058628208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDKV0861619301OtherCAREFIRST
DCW620046OtherCAREFIRST
MD364001900Medicaid
MD364001900Medicaid
H66264Medicare UPIN