Healthcare Provider Details

I. General information

NPI: 1225038581
Provider Name (Legal Business Name): IHAB M SHAFIK MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2005
Last Update Date: 08/13/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18 LIMESTONE DR SUITE 5
WILLIAMSVILLE NY
14221-8602
US

IV. Provider business mailing address

18 LIMESTONE DR SUITE 5
WILLIAMSVILLE NY
14221-8602
US

V. Phone/Fax

Practice location:
  • Phone: 716-632-1400
  • Fax: 716-632-5316
Mailing address:
  • Phone: 716-632-1400
  • Fax: 716-632-5316

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number199994
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: