MEDICARE: NOURAN YASSER ELSHAHAT ESHAK MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RR0500X	Rheumatology Physician	68794	AZ

General Provider Information

NPI Number	:	1073175022
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NOURAN YASSER ELSHAHAT ESHAK MD

Provider Business Mailing Address
First Line	:	2400 S AVENUE A
Second Line	:
City	:	YUMA
State	:	AZ
Zip	:	85364-7127
Country	:	US
Telephone Number	:	928-344-2000
Fax Number	:

Provider Business Practice Location Address
First Line	:	2851 S AVENUE B BLDG 20
Second Line	:
City	:	YUMA
State	:	AZ
Zip	:	85364-7726
Country	:	US
Telephone Number	:	928-336-2434
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/30/2019
Last Update Date	:	04/10/2026

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