MEDICARE: SHEHAB FOIZ IMAM DO

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	208M00000X	Hospitalist Physician	2024-01837	NC
2	207R00000X	Internal Medicine Physician	LL83274	SC

General Provider Information

NPI Number	:	1669098604
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHEHAB FOIZ IMAM DO

Provider Business Mailing Address
First Line	:	MEDICAL CENTER BLVD
Second Line	:
City	:	WINSTON SALEM
State	:	NC
Zip	:	27157-0001
Country	:	US
Telephone Number	:	336-716-9252
Fax Number	:	336-716-0030

Provider Business Practice Location Address
First Line	:	MEDICAL CENTER BLVD
Second Line	:
City	:	WINSTON SALEM
State	:	NC
Zip	:	27157-0001
Country	:	US
Telephone Number	:	336-716-9252
Fax Number	:	336-716-0030

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

Provider Enumeration Date	:	06/24/2020
Last Update Date	:	01/20/2026

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