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NPI Code Detail

MEDICARE: FADI SHAMOUN MD

MEDICARE: FADI SHAMOUN MD
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
1207RC0000XCardiovascular Disease Physician59979MN
2207RC0000XCardiovascular Disease Physician43128AZ

General Provider Information

NPI Number : 1225038250
Entity Type Code : Individual
Provider Name (Legal Business Name) : FADI SHAMOUN MD
Provider Business Mailing Address
First Line : 13400 E SHEA BLVD
Second Line :
City : SCOTTSDALE
State : AZ
Zip : 85259-5452
Country : US
Telephone Number : 480-301-8000
Fax Number :
Provider Business Practice Location Address
First Line : 200 1ST ST SW
Second Line :
City : ROCHESTER
State : MN
Zip : 55905-5452
Country : US
Telephone Number : 507-284-2511
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/01/2005
Last Update Date : 09/03/2020

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