Provider Demographics
NPI:1497717516
Name:SHEHATA, AHMED ABDELHALIM (MD)
Entity Type:Individual
Prefix:
First Name:AHMED
Middle Name:ABDELHALIM
Last Name:SHEHATA
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 1:1939 E ROUTE 70
Mailing Address - Street 2:SUITE 250
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08003-4507
Mailing Address - Country:US
Mailing Address - Phone:856-429-4433
Mailing Address - Fax:856-424-6732
Practice Address - Street 1:1939 E ROUTE 70
Practice Address - Street 2:SUITE 250
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08003-4507
Practice Address - Country:US
Practice Address - Phone:856-429-4433
Practice Address - Fax:856-424-6732
Is Sole Proprietor?:No
Enumeration Date:2006-04-04
Last Update Date:2020-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07221900207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ100016737OtherMEDICARE RAILROAD
NJ2144160000OtherKEYSTONE
NJ222083813OtherBLUE SHIELD
PA1459125OtherBLUE SHIELD
NJ194704OtherAMERIGROUP
NJ2144160000OtherAMERIHEALTH
NJ2224408OtherFIRST HEALTH
NJ2590604OtherGHI
NJ2K7156OtherPHS/HEALTHNET
NJ9013202Medicaid
NJP3276244OtherOXFORD
NJ1167311OtherHORIZON MERCY
NJ3072924OtherAETNA
NJ01000622300OtherAMERICHOICE
NJ1149835002OtherCIGNA
NJ2135954OtherUNITED HEALTHCARE
NJ3072924OtherAETNA
NJ9013202Medicaid