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NPI Code Detail

MEDICARE: AHMAD H. SHATILA, M.D.

MEDICARE: AHMAD H. SHATILA, 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
12086X0206XSurgical Oncology Physician35039162SOH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11568562031OTHEROHNPI

General Provider Information

NPI Number : 1407072911
Entity Type Code : Organization
Provider Name (Legal Business Name) : AHMAD H. SHATILA, M.D.
Provider Business Mailing Address
First Line : 18660 BAGLEY RD
Second Line : STE. 305 BUILDING 2
City : MIDDLEBURG HEIGHTS
State : OH
Zip : 44130-3483
Country : US
Telephone Number : 440-234-9338
Fax Number : 440-234-1448
Provider Business Practice Location Address
First Line : 18660 BAGLEY RD
Second Line : STE. 305 BUILDING 2
City : MIDDLEBURG HEIGHTS
State : OH
Zip : 44130-3483
Country : US
Telephone Number : 440-234-9338
Fax Number : 440-234-1448
Authorized Official
Title or Position : PHYSICIAN-OWNER
Name : DR. AHMAD H. SHATILA
Credential : M.D.
Telephone Number : 440-234-9338
Provider Enumeration Date : 04/17/2007
Last Update Date : 08/22/2020

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