Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1223P0106X | Oral and Maxillofacial Pathology | 30-021959 | OH |
Y | 1223S0112X | Oral and Maxillofacial Surgeon | 2011010943 | MO |
NPI | 1275731895 |
---|---|
Provider Name | Dr. Rishad Shaikh |
First Address | St. Louis, MO 63141 |
Second Address | Saint Louis, MO 63141-8232 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/07/2007 |
Last Update Date | 15/09/2014 |