Provider Demographics
NPI:1558525238
Name:AHMAD SHANABLEH M.D.INC, A MEDICAL CORPORATION
Entity Type:Organization
Organization Name:AHMAD SHANABLEH M.D.INC, A MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:AHMAD
Authorized Official - Middle Name:M
Authorized Official - Last Name:SHANABLEH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:504-341-1603
Mailing Address - Street 1:824 AVENUE F
Mailing Address - Street 2:
Mailing Address - City:MARRERO
Mailing Address - State:LA
Mailing Address - Zip Code:70072-1940
Mailing Address - Country:US
Mailing Address - Phone:504-341-1603
Mailing Address - Fax:504-341-1613
Practice Address - Street 1:824 AVENUE F
Practice Address - Street 2:
Practice Address - City:MARRERO
Practice Address - State:LA
Practice Address - Zip Code:70072-1940
Practice Address - Country:US
Practice Address - Phone:504-341-1603
Practice Address - Fax:504-341-1641
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-11
Last Update Date:2023-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty