MEDICARE: SHAQUELA MAHDEE-MOORE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251J00000X	Nursing Care Agency	7717617	OH

General Provider Information

NPI Number	:	1205605284
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHAQUELA MAHDEE-MOORE

Provider Business Mailing Address
First Line	:	899 BAIRD ST
Second Line	:
City	:	AKRON
State	:	OH
Zip	:	44306-1556
Country	:	US
Telephone Number	:	234-226-3466
Fax Number	:

Provider Business Practice Location Address
First Line	:	899 BAIRD ST
Second Line	:
City	:	AKRON
State	:	OH
Zip	:	44306-1556
Country	:	US
Telephone Number	:	234-226-3466
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/01/2024
Last Update Date	:	02/04/2026

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Directions to “ SHAQUELA MAHDEE-MOORE ” Practice Location

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