Provider Demographics
NPI:1346232246
Name:SHENOUDA, HANY S (MD)
Entity Type:Individual
Prefix:DR
First Name:HANY
Middle Name:S
Last Name:SHENOUDA
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 1:101 S RAVENEL ST STE 300
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29506-2621
Mailing Address - Country:US
Mailing Address - Phone:843-777-7490
Mailing Address - Fax:843-777-7480
Practice Address - Street 1:101 S RAVENEL ST STE 300
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29506-2621
Practice Address - Country:US
Practice Address - Phone:843-777-7490
Practice Address - Fax:843-777-7480
Is Sole Proprietor?:No
Enumeration Date:2005-08-17
Last Update Date:2022-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI22890207RE0101X
MDD90443207RE0101X
NH17595207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5901654Medicaid
FL266567100Medicaid
NH3104132Medicaid
NC1346232246Medicaid
SCN01349Medicaid
NH3104132Medicaid
FL266567100Medicaid
NCNCC225AMedicare PIN
NC1346232246Medicaid
FL3788342Medicare PIN
NC2044754Medicare PIN