Provider Demographics
NPI:1376920736
Name:SHEHAB ELDIN, MOHAMED (MD)
Entity Type:Individual
Prefix:
First Name:MOHAMED
Middle Name:
Last Name:SHEHAB ELDIN
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 1:501 HOWARD AVE STE E3
Mailing Address - Street 2:
Mailing Address - City:ALTOONA
Mailing Address - State:PA
Mailing Address - Zip Code:16601-4817
Mailing Address - Country:US
Mailing Address - Phone:814-889-3930
Mailing Address - Fax:
Practice Address - Street 1:501 HOWARD AVE STE E3
Practice Address - Street 2:
Practice Address - City:ALTOONA
Practice Address - State:PA
Practice Address - Zip Code:16601-4817
Practice Address - Country:US
Practice Address - Phone:814-889-3930
Practice Address - Fax:814-944-2403
Is Sole Proprietor?:No
Enumeration Date:2015-05-05
Last Update Date:2022-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXBP100525092084N0400X
PAMD4694962084N0400X, 2084V0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084V0102XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyVascular Neurology
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology