Provider Demographics
NPI:1164455101
Name:SHAMMA, ZAINAB (MD)
Entity Type:Individual
Prefix:DR
First Name:ZAINAB
Middle Name:
Last Name:SHAMMA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:176 DAWKINS DR
Mailing Address - Street 2:
Mailing Address - City:LEWISBURG
Mailing Address - State:WV
Mailing Address - Zip Code:24901-9302
Mailing Address - Country:US
Mailing Address - Phone:304-793-3530
Mailing Address - Fax:
Practice Address - Street 1:176 DAWKINS DR
Practice Address - Street 2:
Practice Address - City:LEWISBURG
Practice Address - State:WV
Practice Address - Zip Code:24901-9302
Practice Address - Country:US
Practice Address - Phone:304-647-1148
Practice Address - Fax:304-793-2208
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-09
Last Update Date:2020-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV15358207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0071049000Medicaid
WV021OtherMTST BCBS
WV282383OtherANTHEM BCBS
WV4502260OtherAETNA
WV58176OtherSOUTHERN HEALTH
WV110083097OtherRAILROAD MEDICARE
WV249373OtherMAMSI
WV124146001OtherCIGNA
WV282383OtherANTHEM BCBS
WVB69749Medicare UPIN
0754350001Medicare NSC