Provider Demographics
NPI:1720729700
Name:SHAHWAN, MANAR YAHIA HAMDAN (MD)
Entity Type:Individual
Prefix:
First Name:MANAR
Middle Name:YAHIA HAMDAN
Last Name:SHAHWAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4851 MEADOWBROOK PKWY UNIT 412
Mailing Address - Street 2:
Mailing Address - City:PRAIRIE VILLAGE
Mailing Address - State:KS
Mailing Address - Zip Code:66207-3496
Mailing Address - Country:US
Mailing Address - Phone:617-378-1801
Mailing Address - Fax:
Practice Address - Street 1:1402 S GRAND BLVD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63104-1004
Practice Address - Country:US
Practice Address - Phone:314-977-4547
Practice Address - Fax:314-977-7615
Is Sole Proprietor?:No
Enumeration Date:2022-04-05
Last Update Date:2022-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program