Provider Demographics
NPI:1891511887
Name:SHAIK ABDUL MD LLC
Entity type:Organization
Organization Name:SHAIK ABDUL MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:SAMEER-TAJUDDEN
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAIK-ABDUL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:469-469-8365
Mailing Address - Street 1:3659 ROSANAH ST
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75033-1738
Mailing Address - Country:US
Mailing Address - Phone:469-469-8365
Mailing Address - Fax:
Practice Address - Street 1:220 TILGHMAN RD
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:MD
Practice Address - Zip Code:21804-1921
Practice Address - Country:US
Practice Address - Phone:469-469-8365
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-25
Last Update Date:2024-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty