Provider Demographics
NPI:1992980544
Name:ASIF, SHAHIDA (MD)
Entity type:Individual
Prefix:DR
First Name:SHAHIDA
Middle Name:
Last Name:ASIF
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 1:1631-A E. HIGHWAY 66
Mailing Address - Street 2:
Mailing Address - City:EL -RENO
Mailing Address - State:OK
Mailing Address - Zip Code:73036-5769
Mailing Address - Country:US
Mailing Address - Phone:405-262-7631
Mailing Address - Fax:405-262-8099
Practice Address - Street 1:1631 E US HIGHWAY 66
Practice Address - Street 2:
Practice Address - City:EL RENO
Practice Address - State:OK
Practice Address - Zip Code:73036-5769
Practice Address - Country:US
Practice Address - Phone:405-262-7631
Practice Address - Fax:405-262-8099
Is Sole Proprietor?:No
Enumeration Date:2008-01-02
Last Update Date:2011-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101242729207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine