MEDICARE: YAHYA EL-SHINNAWY

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	208000000X	Pediatrics Physician	38125	IA

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	:	1619914140
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YAHYA EL-SHINNAWY

Provider Business Mailing Address
First Line	:	8003 CASTLEWAY DR
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46250-1946
Country	:	US
Telephone Number	:	317-576-1335
Fax Number	:

Provider Business Practice Location Address
First Line	:	1901 W WESTERN AVE
Second Line	:
City	:	SOUTH BEND
State	:	IN
Zip	:	46619-3569
Country	:	US
Telephone Number	:	317-576-1335
Fax Number	:

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

Provider Enumeration Date	:	06/01/2006
Last Update Date	:	01/24/2023

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Directions to “ YAHYA EL-SHINNAWY ” Practice Location

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