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General NPI Number Information
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NPI Number | 1336109545
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Entity Type | Individual
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Provider Name | EMAD R SHENOUDA MD
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Gender | Male
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Dates
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Enumeration Date | 03/23/2006
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Last Update Date | 11/03/2014
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Provider Practice Location Address
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Address Line | 7011 DOUGLAS AVE
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City | DES MOINES
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State | IA
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Zip | 50322-3223
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Country | US
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Telephone | 515-333-3333
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Fax | 515-362-7933
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Provider Business Mailing Address
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Address Line | PO BOX 7703
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City | DES MOINES
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State | IA
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Zip | 50323-7703
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Country | US
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Telephone | 515-333-3333
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Fax | 515-283-2020
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 33949
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License Number State | IA
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