Provider Demographics
NPI:1568615193
Name:SHAMA, ZOUHEIR A SR (MD)
Entity Type:Individual
Prefix:MR
First Name:ZOUHEIR
Middle Name:A
Last Name:SHAMA
Suffix:SR
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 1:2536 COSMOS DRIVE N.E.
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30345
Mailing Address - Country:US
Mailing Address - Phone:404-636-0471
Mailing Address - Fax:404-636-0471
Practice Address - Street 1:2536 COSMOS DRIVE N.E.
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30345
Practice Address - Country:US
Practice Address - Phone:404-636-0471
Practice Address - Fax:404-636-0471
Is Sole Proprietor?:No
Enumeration Date:2008-10-28
Last Update Date:2008-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA14720208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00085599HMedicaid
GA02BDDXRMedicare PIN
GAD41091Medicare UPIN