| Doctor Name: | HAITHAM SHAHROUR |
| NPI Number: | 1184927444 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | |
| Business Practice Address: | 1000 Alliance Drive Hazleton, PA - 182023234 |
| Business Phone Number: | 5705016400 |
| Business Fax Number: | 5704532353 |
| Mailing Address: | Po Box 1347, KINGSTON |
| State: | PA |
| Postal Code: | 187040347 |
| Phone Number: | 5702888881 |
| Fax Number: | 5702888065 |
| NPI Enumeration Date: | 12/08/2010 |
| NPI Last Update Date: | 12/15/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 390200000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Student, Health Care |
| Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |