Provider Demographics
NPI:1922172832
Name:BAKY, EMAD SHAWKY (M D)
Entity Type:Individual
Prefix:DR
First Name:EMAD
Middle Name:SHAWKY
Last Name:BAKY
Suffix:
Gender:M
Credentials:M D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6636 COVINGTON CV
Mailing Address - Street 2:
Mailing Address - City:CANFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44406-8161
Mailing Address - Country:US
Mailing Address - Phone:330-505-9581
Mailing Address - Fax:330-505-9571
Practice Address - Street 1:1252 YOUNGSTOWN WARREN RD
Practice Address - Street 2:SUITE B
Practice Address - City:NILES
Practice Address - State:OH
Practice Address - Zip Code:44446-4650
Practice Address - Country:US
Practice Address - Phone:330-505-9581
Practice Address - Fax:330-505-9571
Is Sole Proprietor?:No
Enumeration Date:2006-11-20
Last Update Date:2020-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35076270207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2217390Medicaid
OH2217390Medicaid
OHBA7281421Medicare ID - Type Unspecified