Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207N00000X | Dermatologist | 82218 | GA |
Y | 207ND0101X | MOHS-Micrographic Surgeon | 82218 | GA |
NPI | 1063858363 |
---|---|
Provider Name | Dr. Waqas R Shaikh |
First Address | Snellville, GA 30078-3250 |
Second Address | Snellville, GA 30078 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/05/2013 |
Last Update Date | 07/11/2020 |