MEDICARE: DR. ANGIE MARIE ELSHEIKH M.D.

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	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	35092814	OH
2	207ZC0500X	Cytopathology Physician	35.092814	OH

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	:	1366644049
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANGIE MARIE ELSHEIKH M.D.

Provider Business Mailing Address
First Line	:	3535 SOUTHERN BLVD
Second Line	:
City	:	KETTERING
State	:	OH
Zip	:	45429-1221
Country	:	US
Telephone Number	:	937-395-8849
Fax Number	:	937-395-8350

Provider Business Practice Location Address
First Line	:	3535 SOUTHERN BLVD.
Second Line	:
City	:	KETTERING
State	:	OH
Zip	:	45429
Country	:	US
Telephone Number	:	937-395-8849
Fax Number	:	937-395-8350

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

Provider Enumeration Date	:	06/04/2007
Last Update Date	:	02/09/2026

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