Provider Demographics
NPI:1477533289
Name:SHAMAS, GILBERT ANTHONY (MD)
Entity Type:Individual
Prefix:
First Name:GILBERT
Middle Name:ANTHONY
Last Name:SHAMAS
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 1:5501 4TH ST N
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33703-2251
Mailing Address - Country:US
Mailing Address - Phone:727-527-2590
Mailing Address - Fax:
Practice Address - Street 1:5501 4TH ST N
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33703-2251
Practice Address - Country:US
Practice Address - Phone:727-527-2590
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-18
Last Update Date:2010-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 29126207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL036599800Medicaid
FL036599800Medicaid
FL52958YMedicare ID - Type Unspecified