Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204F00000X | Transplant Surgeon | 275722 | NY |
N | 204F00000X | Transplant Surgeon | A121450 | CA |
N | 204F00000X | Transplant Surgeon | ME126757 | FL |
Y | 208200000X | Surgeon | ME126757 | FL |
Y | 208600000X | Surgeon | ME126757 | FL |
NPI | 1194981498 |
---|---|
Provider Name | Dr. Imtiazuddin Shaik |
First Address | Lutz, FL 33548-2667 |
Second Address | Valhalla, NY 10595-1530 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/08/2008 |
Last Update Date | 14/06/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1194981498 | (05) | CA |