Provider Demographics
NPI:1851523658
Name:DR.MAHMOUD SHEHATA M.D LCC
Entity Type:Organization
Organization Name:DR.MAHMOUD SHEHATA M.D LCC
Other - Org Name:UPPER ARLINGTON BEHAVIORAL HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/LLC MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:MAHMOUD
Authorized Official - Middle Name:EL-SAID
Authorized Official - Last Name:SHEHATA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:614-451-8400
Mailing Address - Street 1:2000 W HENDERSON RD
Mailing Address - Street 2:230
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43220-2453
Mailing Address - Country:US
Mailing Address - Phone:614-451-8400
Mailing Address - Fax:614-451-8402
Practice Address - Street 1:2000 W HENDERSON RD
Practice Address - Street 2:230
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43220-2453
Practice Address - Country:US
Practice Address - Phone:614-451-8400
Practice Address - Fax:614-451-8402
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-13
Last Update Date:2009-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.0677422084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty