Provider Demographics
NPI:1982806014
Name:SHAWISH, HISHAM M (MD)
Entity Type:Individual
Prefix:
First Name:HISHAM
Middle Name:M
Last Name:SHAWISH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:100 SHENANGO AVE
Mailing Address - Street 2:
Mailing Address - City:SHARON
Mailing Address - State:PA
Mailing Address - Zip Code:16146-1503
Mailing Address - Country:US
Mailing Address - Phone:814-455-5505
Mailing Address - Fax:814-455-5515
Practice Address - Street 1:650 EAST AVE
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16503-1524
Practice Address - Country:US
Practice Address - Phone:814-455-5505
Practice Address - Fax:814-455-5515
Is Sole Proprietor?:No
Enumeration Date:2007-06-01
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD439870207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0087455Medicaid
PA102481835Medicaid
PA102481835Medicaid