Provider Demographics
NPI:1215123971
Name:ABU-SHAHIN, FADI ISMAIL (MD)
Entity type:Individual
Prefix:DR
First Name:FADI
Middle Name:ISMAIL
Last Name:ABU-SHAHIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:18220 STATE HIGHWAY 249 STE 130
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77070-4371
Mailing Address - Country:US
Mailing Address - Phone:281-737-0435
Mailing Address - Fax:281-737-0439
Practice Address - Street 1:127 HEALTH CARE DR
Practice Address - Street 2:SUITE 9
Practice Address - City:PENNINGTON GAP
Practice Address - State:VA
Practice Address - Zip Code:24277-2853
Practice Address - Country:US
Practice Address - Phone:276-546-2928
Practice Address - Fax:276-546-2921
Is Sole Proprietor?:No
Enumeration Date:2007-09-17
Last Update Date:2022-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101250908207RX0202X
TN48715207RX0202X
TXR7364207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN103I117125Medicare PIN
VAVV6496Medicare PIN