Provider Demographics
NPI:1902105588
Name:SHAIKH, DAANISH KHALID (MD)
Entity type:Individual
Prefix:
First Name:DAANISH
Middle Name:KHALID
Last Name:SHAIKH
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 1:22 CHAPEL ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11201-1903
Mailing Address - Country:US
Mailing Address - Phone:718-260-2900
Mailing Address - Fax:907-290-3227
Practice Address - Street 1:2451 E BASELINE RD STE 430
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85234-2473
Practice Address - Country:US
Practice Address - Phone:602-313-4391
Practice Address - Fax:480-699-4427
Is Sole Proprietor?:No
Enumeration Date:2011-03-21
Last Update Date:2025-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ752922083A0300X
IL036136381207Q00000X
WI64553-20207Q00000X
CT055269207QA0401X
NY00293900207QA0401X
MA10199032083A0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083A0300XAllopathic & Osteopathic PhysiciansPreventive MedicineAddiction Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00293900OtherMEDICAL LICENSE
CT055269OtherSTATE
IL036136381OtherMEDICAL LICENSE