Provider Demographics
NPI:1013477389
Name:SHUBAIR, SWHAEB (MD)
Entity Type:Individual
Prefix:DR
First Name:SWHAEB
Middle Name:
Last Name:SHUBAIR
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 1:1201 SAGEWOOD PL SW
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:36265-3727
Mailing Address - Country:US
Mailing Address - Phone:404-680-7450
Mailing Address - Fax:
Practice Address - Street 1:205 SOUTH FRONT STREET
Practice Address - Street 2:BRADY 916
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17105
Practice Address - Country:US
Practice Address - Phone:717-231-8755
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-22
Last Update Date:2024-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
PAMT224495208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program