Provider Demographics
NPI:1780924506
Name:ISMAIL A. SHALABY, MD., P.A.
Entity type:Organization
Organization Name:ISMAIL A. SHALABY, MD., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ISMAIL
Authorized Official - Middle Name:AHMAD
Authorized Official - Last Name:SHALABY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:410-675-0050
Mailing Address - Street 1:2801 HUDSON STREET
Mailing Address - Street 2:UPPER LEVEL SUITE C
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21224
Mailing Address - Country:US
Mailing Address - Phone:410-675-0050
Mailing Address - Fax:410-675-4692
Practice Address - Street 1:2801 HUDSON STREET
Practice Address - Street 2:UPPER LEVEL SUITE C
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21224
Practice Address - Country:US
Practice Address - Phone:410-675-0050
Practice Address - Fax:410-675-4692
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-15
Last Update Date:2013-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty