Basic Information
| Provider Information | |||||||||
| NPI: | 1104080308 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SHEIKH | ||||||||
| FirstName: | MUJEEB | ||||||||
| MiddleName: | A. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3355 GLENDALE AVE FL 3 | ||||||||
| Address2: | |||||||||
| City: | TOLEDO | ||||||||
| State: | OH | ||||||||
| PostalCode: | 436142426 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4199310030 | ||||||||
| FaxNumber: | 4199310032 | ||||||||
| Practice Location | |||||||||
| Address1: | 28442 E RIVER RD | ||||||||
| Address2: | |||||||||
| City: | PERRYSBURG | ||||||||
| State: | OH | ||||||||
| PostalCode: | 435512795 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4199310030 | ||||||||
| FaxNumber: | 4199310032 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/16/2008 | ||||||||
| LastUpdateDate: | 03/29/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 35093841 | OH | N | Allopathic & Osteopathic Physicians | Internal Medicine | 208M00000X | 35093841 | OH | N | Allopathic & Osteopathic Physicians | Hospitalist | 207RC0000X | 35.093841 | OH | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease |
ID Information
| ID | Type | State | Issuer | Description | 2969720 | 05 | OH | MEDICAID |