Doctor Name: | DR. ISSAM MAHMOUD SHEBARO |
NPI Number: | 1023176013 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | 0101045171 |
Business Practice Address: | 11445 Sunset Hills Road Reston, VA - 201905276 |
Business Phone Number: | 7037091500 |
Business Fax Number: | 7037091711 |
Mailing Address: | 2101 E Jefferson St Ppqa Medicare Compliance Unit 6 W, Kaiser Permanente Midatlantic Permanente Medical Grp Pc ROCKVILLE |
State: | MD |
Postal Code: | 208524908 |
Phone Number: | 3018162424 |
Fax Number: | 3018166308 |
NPI Enumeration Date: | 12/04/2006 |
NPI Last Update Date: | 11/18/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 207V00000X |
License Number: | 0101045171 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | VA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Obstetrics & Gynecology |
Taxonomy Specialization: | |
Taxonomy Definition: | An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |