Provider Demographics
NPI:1407969587
Name:SHALABY, WALEED (MD)
Entity Type:Individual
Prefix:DR
First Name:WALEED
Middle Name:
Last Name:SHALABY
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 1:1100 N GRANT AVE
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19805-2671
Mailing Address - Country:US
Mailing Address - Phone:302-421-4670
Mailing Address - Fax:
Practice Address - Street 1:1100 N GRANT AVE
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19805-2671
Practice Address - Country:US
Practice Address - Phone:302-421-4670
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-16
Last Update Date:2008-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD067880L207VX0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0201XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologic Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1013475660001Medicaid
PA093002KZKMedicare PIN
PA1013475660001Medicaid