MEDICARE: DR. ABDALLAH AL-SHAHED 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	207R00000X	Internal Medicine Physician	35085379	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000000364131	OTHER	OH	ANTHEM
2	1052	OTHER	OH	SUMMA
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1639159528
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ABDALLAH AL-SHAHED MD

Provider Business Mailing Address
First Line	:	2995 FOREST LAKE DRIVE
Second Line	:
City	:	WESTLAKE
State	:	OH
Zip	:	44145
Country	:	US
Telephone Number	:	440-242-5320
Fax Number	:	440-471-7113

Provider Business Practice Location Address
First Line	:	2995 FOREST LAKE DR
Second Line	:
City	:	WESTLAKE
State	:	OH
Zip	:	44145-1729
Country	:	US
Telephone Number	:	440-242-5320
Fax Number	:	440-471-7113

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

Provider Enumeration Date	:	01/18/2006
Last Update Date	:	03/20/2013

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