Individual
FAWAD A. SHAHEEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
335 31ST ST S, ST PETERSBURG, FL 33712-1419
(727) 289-7139
(727) 289-7140
Mailing address
PO BOX 636256 CENTRAL CREDENTIALING, CINCINNATI, OH 45263-0001
(513) 585-5504
(513) 585-5511
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
MD2022-1142
NM
2085R0202X
Diagnostic Radiology Physician
ME111493
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
HP383U
MEDICARE
FL
05
—
PENDING
—
FL
Enumeration date
09/17/2008
Last updated
09/12/2022
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