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General NPI Number Information
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NPI Number | 1891881231
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Entity Type | Individual
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Provider Name | ESSAM D SHIHADEH MD
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Gender | Male
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Dates
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Enumeration Date | 10/05/2006
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Last Update Date | 02/15/2017
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Provider Practice Location Address
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Address Line | 1650 COWLES STREET
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City | FAIRBANKS
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State | AK
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Zip | 99701
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Country | US
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Telephone | 907-458-5380
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Fax | 907-743-2641
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Provider Business Mailing Address
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Address Line | P.O. BOX 24571 MAILSTOP 3100117
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City | SEATTLE
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State | WA
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Zip | 98124-0571
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Country | US
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Telephone | 907-452-5380
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Fax | 907-458-6984
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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 | 2085R0001X
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Taxonomy Name | Radiation Oncology Physician
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License Number | 4498
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License Number State | AK
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