Provider Demographics
NPI:1164626362
Name:ELSHEIKH, IBRAHIM (MD)
Entity Type:Individual
Prefix:
First Name:IBRAHIM
Middle Name:
Last Name:ELSHEIKH
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 1:5 SEVERANCE CIR
Mailing Address - Street 2:SUITE 107
Mailing Address - City:CLEVELAND HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44118-1566
Mailing Address - Country:US
Mailing Address - Phone:216-382-4974
Mailing Address - Fax:216-382-4981
Practice Address - Street 1:5 SEVERANCE CIR
Practice Address - Street 2:SUITE 107
Practice Address - City:CLEVELAND HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44118-1566
Practice Address - Country:US
Practice Address - Phone:216-382-4974
Practice Address - Fax:216-382-4981
Is Sole Proprietor?:No
Enumeration Date:2007-06-12
Last Update Date:2018-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3592977208M00000X, 208000000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1457NOtherBLUE CROSS BLUE SHIELD OF FLORIDA
OH3075443Medicaid
FL512240OtherSTAYWELL/HEALTHEASE
FL001053300Medicaid
FL331682OtherAVMED
FL5900049OtherCIGNA
FL9082404OtherAETNA