Basic Information
| Provider Information | |||||||||
| NPI: | 1992921811 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SHEIKH | ||||||||
| FirstName: | SELIM | ||||||||
| MiddleName: | UDDIN | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2312 WHITEHORSE MERCERVILLE RD | ||||||||
| Address2: | SUITE 100 | ||||||||
| City: | HAMILTON | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 086191953 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6095866244 | ||||||||
| FaxNumber: | 6095866221 | ||||||||
| Practice Location | |||||||||
| Address1: | 2312 WHITEHORSE MERCERVILLE RD | ||||||||
| Address2: | SUITE 100 | ||||||||
| City: | HAMILTON | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 086191953 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6095866244 | ||||||||
| FaxNumber: | 6095866221 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/18/2007 | ||||||||
| LastUpdateDate: | 09/13/2016 | ||||||||
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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 | 173000000X | 25MA06108000 | NJ | N | Other Service Providers | Legal Medicine | 207R00000X | 25MA06108000 | NJ | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 6749704 | 05 | NJ | MEDICAID |