Provider Demographics
NPI:1538256342
Name:SHICK, HERBERT (MD)
Entity type:Individual
Prefix:
First Name:HERBERT
Middle Name:
Last Name:SHICK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3800 JOHNSON ST
Mailing Address - Street 2:STE C
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33021
Mailing Address - Country:US
Mailing Address - Phone:954-962-4700
Mailing Address - Fax:954-962-1707
Practice Address - Street 1:3800 JOHNSON ST STE C
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-6030
Practice Address - Country:US
Practice Address - Phone:954-962-4700
Practice Address - Fax:954-962-1707
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-05
Last Update Date:2017-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME11540207R00000X, 207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine