Provider Demographics
NPI:1790730133
Name:ELSHATORY, KAREEM MOHAMED (MD)
Entity Type:Individual
Prefix:DR
First Name:KAREEM
Middle Name:MOHAMED
Last Name:ELSHATORY
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 1:129 SHELBY TRCE
Mailing Address - Street 2:
Mailing Address - City:MURPHY
Mailing Address - State:TX
Mailing Address - Zip Code:75094-3783
Mailing Address - Country:US
Mailing Address - Phone:469-305-9817
Mailing Address - Fax:
Practice Address - Street 1:1745 N BELT LINE RD
Practice Address - Street 2:
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75149
Practice Address - Country:US
Practice Address - Phone:469-917-9780
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-24
Last Update Date:2024-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ6828207R00000X, 207P00000X
CAA87811207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1469840Medicaid
TX3580995Medicaid
LAI18662Medicare UPIN