MEDICARE: DR. AMMAR SHAMMAA 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	207V00000X	Obstetrics & Gynecology Physician	ME172604	FL
2	207V00000X	Obstetrics & Gynecology Physician	22915	WV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1356478663
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AMMAR SHAMMAA MD

Provider Business Mailing Address
First Line	:	PO BOX 1289
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33601-1289
Country	:	US
Telephone Number	:	352-686-8888
Fax Number	:	352-684-6888

Provider Business Practice Location Address
First Line	:	4803 KENTUCKY ST
Second Line	:
City	:	SOUTH CHARLESTON
State	:	WV
Zip	:	25309-1309
Country	:	US
Telephone Number	:	304-766-9600
Fax Number	:	304-766-9606

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

Provider Enumeration Date	:	02/27/2007
Last Update Date	:	01/14/2026

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