Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0201X | Gynecologic Oncologist | MD067880L | PA |
NPI | 1407969587 |
---|---|
Provider Name | Dr. Waleed Shalaby |
First Address | Wilmington, DE 19805-2671 |
Second Address | Wilmington, DE 19805-2671 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/08/2006 |
Last Update Date | 04/03/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1013475660001 | (05) | PA |
H87538 | (02) | PA |