Individual
DR. IMAM H SHAIK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
800 E DAWSON ST, TYLER, TX 75701-2036
(903) 606-4129
Mailing address
PO BOX 846098, DALLAS, TX 75284-6098
(903) 324-6400
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
26546
WV
208M00000X
Hospitalist Physician
Primary
R2222
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1F0470
MEDICARE
TX
05
—
376411002
—
TX
Enumeration date
03/28/2014
Last updated
05/03/2024
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