Provider Demographics
NPI:1861456378
Name:ELSHARKAWI, AHMED (MD)
Entity Type:Individual
Prefix:
First Name:AHMED
Middle Name:
Last Name:ELSHARKAWI
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 1:3025 SHRINE RD STE 270
Mailing Address - Street 2:
Mailing Address - City:BRUNSWICK
Mailing Address - State:GA
Mailing Address - Zip Code:31520-4785
Mailing Address - Country:US
Mailing Address - Phone:912-262-2723
Mailing Address - Fax:912-264-5609
Practice Address - Street 1:3025 SHRINE RD STE 270
Practice Address - Street 2:
Practice Address - City:BRUNSWICK
Practice Address - State:GA
Practice Address - Zip Code:31520-4785
Practice Address - Country:US
Practice Address - Phone:912-262-2723
Practice Address - Fax:912-264-5609
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-12
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA55128207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA663552717KMedicaid
GA663552717MMedicaid
GA663552717JMedicaid
GA663552717RMedicaid
GA663552717PMedicaid
GA055128OtherGA STATE LICENSE
GA663552717QMedicaid
GA663552717LMedicaid
GA663552717PMedicaid