Shammout, Khaled M

Shammout, Khaled M is an individual health care provider with primary practice located at 1600 Sw Archer Road, M-509 , Gainesville FL 32610-0254. He recently has only one registered license in Allopathic & Osteopathic Physicians / Hospitalist, which is considered as his primary health care specialty. Shammout, Khaled M can be contacted via phone (352) 265-0486.

Contact Information

Primary practice address
1600 Sw Archer Road, M-509 Gainesville FL 32610-0254
Phone: (352) 265-0486
Fax: (352) 265-1062
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Hospitalist 208M00000X 4301073067 Michigan

Profile Details

NPI number 1356357834
LBN Legal business name Shammout, Khaled M
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 1st, 2006
Last updated Aug 9th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1356357834 NPPES
Michigan Other 1106314852 BCBSM
Michigan MEDICAID 4714307 BCBSM

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