MEDICARE: DR. NABIL S.H.A. MESSIAH PA-C, MBBCH

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	363A00000X	Physician Assistant	PA9105307	FL
2	363AM0700X	Medical Physician Assistant	PA9105307	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	P01046793	OTHER	FL	RAILROAD MEDICARE ATTACHED TO GRP# DR6927

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	Y08C6	OTHER	FL	BCBS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1972502540
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NABIL S.H.A. MESSIAH PA-C, MBBCH

Provider Business Mailing Address
First Line	:	653 W 8TH ST FL 3
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32209-6511
Country	:	US
Telephone Number	:	904-383-1014
Fax Number	:	904-244-5090

Provider Business Practice Location Address
First Line	:	LANDSTUHL REGIONAL MEDICAL CENTER
Second Line	:	CMR402
City	:	APO
State	:	AE
Zip	:	09180
Country	:	US
Telephone Number	:	496371868590
Fax Number	:

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

Provider Enumeration Date	:	07/18/2005
Last Update Date	:	01/22/2018

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