Shadeed, Nadira Soad

Shadeed, Nadira Soad is an sole proprietor health care provider with primary practice located at 2055 Hamilton Creek Pkwy Ste 120 , Dacula GA 30019-7205. She recently has 2 registered licenses in different health care specialties including Eye and Vision Services Providers / Optometrist, Eye and Vision Services Providers / Vision Therapy. Eye and Vision Services Providers / Vision Therapy is her primary health care specialty. Shadeed, Nadira Soad can be contacted via phone (770) 904-0979.

Contact Information

Primary practice address
2055 Hamilton Creek Pkwy Ste 120 Dacula GA 30019-7205
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 2355 Georgia
Eye and Vision Services Providers / Optometrist 152W00000X 1440 South Carolina
Eye and Vision Services Providers / Vision Therapy 152WV0400X 1440 South Carolina
Eye and Vision Services Providers / Vision Therapy 152WV0400X 2355 Georgia

Profile Details

NPI number 1952411969
LBN Legal business name Shadeed, Nadira Soad
Credentials O.D., F.C.O.V.D.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 30th, 2006
Last updated Oct 7th, 2022 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1952411969 NPPES
South Carolina MEDICAID D14401

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