Provider Demographics
NPI:1346778099
Name:SHENODA, BOTROS (MD PHD, MSC)
Entity Type:Individual
Prefix:DR
First Name:BOTROS
Middle Name:
Last Name:SHENODA
Suffix:
Gender:M
Credentials:MD PHD, MSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:ABINGTON PLAZA MEDICAL ASSOCIATES
Mailing Address - Street 2:1235 OLD YORK ROAD SUITE 113
Mailing Address - City:ABINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:19001
Mailing Address - Country:US
Mailing Address - Phone:215-491-5057
Mailing Address - Fax:215-491-5607
Practice Address - Street 1:ABINGTON PLAZA MEDICAL ASSOCIATES
Practice Address - Street 2:1235 OLD YORK ROAD SUITE 113
Practice Address - City:ABINGTON
Practice Address - State:PA
Practice Address - Zip Code:19001
Practice Address - Country:US
Practice Address - Phone:215-491-5057
Practice Address - Fax:215-491-5607
Is Sole Proprietor?:No
Enumeration Date:2017-05-25
Last Update Date:2023-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD470506207R00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine