Provider Demographics
NPI:1780632018
Name:SHABANY, HIND (MD)
Entity Type:Individual
Prefix:DR
First Name:HIND
Middle Name:
Last Name:SHABANY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:HIND
Other - Middle Name:
Other - Last Name:ELBASHITI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:333 FALAISE DR
Mailing Address - Street 2:
Mailing Address - City:CREVE COEUR
Mailing Address - State:MO
Mailing Address - Zip Code:63141-7403
Mailing Address - Country:US
Mailing Address - Phone:314-677-5134
Mailing Address - Fax:
Practice Address - Street 1:13677 W. MCDOWELL RD
Practice Address - Street 2:
Practice Address - City:GOODYEAR
Practice Address - State:AZ
Practice Address - Zip Code:85395
Practice Address - Country:US
Practice Address - Phone:623-882-1500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-05
Last Update Date:2013-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO35487207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO206191413Medicaid
MOP00377494OtherRAILROAD MEDICARE
MO759586OtherHEALTHLINK
MOP00415638OtherRAILROAD MEDICARE
MOP00415638OtherRAILROAD MEDICARE
MO206191413Medicaid
MO930755236Medicare PIN
MO035011545Medicare ID - Type Unspecified