Provider Demographics
NPI:1922315670
Name:SHAMLEFFER, IBTEHAL JARALLA (MD)
Entity Type:Individual
Prefix:
First Name:IBTEHAL
Middle Name:JARALLA
Last Name:SHAMLEFFER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:IBTEHAL
Other - Middle Name:ABDUL KADEM
Other - Last Name:JARALLA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2100 STANTONSBURG RD
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27834-2818
Mailing Address - Country:US
Mailing Address - Phone:336-274-3241
Mailing Address - Fax:
Practice Address - Street 1:301 E WENDOVER AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27401-1230
Practice Address - Country:US
Practice Address - Phone:336-832-3088
Practice Address - Fax:336-832-3080
Is Sole Proprietor?:No
Enumeration Date:2010-09-01
Last Update Date:2021-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2010-01539207R00000X, 207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine