Healthcare Provider Details

I. General information

NPI: 1457089088
Provider Name (Legal Business Name): MOHAMMED ADEL SHEHATA MOHAMMED MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/11/2022
Last Update Date: 02/23/2026
Certification Date: 02/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

620 HOWARD AVE
ALTOONA PA
16601-4804
US

IV. Provider business mailing address

620 HOWARD AVE
ALTOONA PA
16601-4804
US

V. Phone/Fax

Practice location:
  • Phone: 814-889-2400
  • Fax:
Mailing address:
  • Phone: 814-889-2400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberMT224926
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License NumberMD491330
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: