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General NPI Number Information
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NPI Number | 1881761815
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Entity Type | Individual
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Provider Name | ISMAIL AHMAD SHALABY MD PHD
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Gender | Male
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Dates
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Enumeration Date | 11/28/2006
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Last Update Date | 07/02/2010
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Provider Practice Location Address
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Address Line | 2801 HUDSON STREET UPPER LEVEL SUITE C
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City | BALTIMORE
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State | MD
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Zip | 21224
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Country | US
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Telephone | 410-675-0050
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Fax | 410-675-4692
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Provider Business Mailing Address
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Address Line | 1349 WEST SEMINARY AVENUE
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City | LUTHERVILLE
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State | MD
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Zip | 21093
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Country | US
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Telephone | 410-675-0050
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Fax | 410-675-4692
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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 | D0055532
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License Number State | MD
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