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NPI Code Detail

MEDICARE: DR. SAMIR FAYIZ SHABSHAB

MEDICARE: DR. SAMIR FAYIZ SHABSHAB
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
1207RN0300XNephrology PhysicianD0037366MD
2207RN0300XNephrology Physician0101052260VA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1669430823
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SAMIR FAYIZ SHABSHAB
Provider Business Mailing Address
First Line : 8926 WOODYARD RD STE 602
Second Line :
City : CLINTON
State : MD
Zip : 20735-4235
Country : US
Telephone Number : 301-868-9414
Fax Number : 301-868-6055
Provider Business Practice Location Address
First Line : 8926 WOODYARD RD STE 602
Second Line :
City : CLINTON
State : MD
Zip : 20735-4235
Country : US
Telephone Number : 301-868-9414
Fax Number : 301-868-6055
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/03/2006
Last Update Date : 04/16/2026

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Directions to “ DR. SAMIR FAYIZ SHABSHAB ” Practice Location

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