MEDICARE: DR. OMER SHAHAB M.D.

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	207RG0100X	Gastroenterology Physician	0101265214	VA
2	390200000X	Student in an Organized Health Care Education/Training Program	0116029011	VA
3	207RG0100X	Gastroenterology Physician	D0105810	MD

General Provider Information

NPI Number	:	1750739009
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. OMER SHAHAB M.D.

Provider Business Mailing Address
First Line	:	6201 GREENLEIGH AVE
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21220-2004
Country	:	US
Telephone Number	:	410-933-6423
Fax Number	:

Provider Business Practice Location Address
First Line	:	1715 NORTH GEORGE MASON DRIVE SUITE 410
Second Line	:
City	:	ARLINGTON
State	:	VA
Zip	:	22205
Country	:	US
Telephone Number	:	703-524-4792
Fax Number	:	703-276-7487

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

Provider Enumeration Date	:	05/27/2016
Last Update Date	:	05/19/2026

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Directions to “ DR. OMER SHAHAB M.D.” Practice Location

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