Provider Demographics
NPI:1215916986
Name:SHENOUDA, EMEIL
Entity type:Individual
Prefix:
First Name:EMEIL
Middle Name:
Last Name:SHENOUDA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2347 FIFTH AVE
Mailing Address - Street 2:UPMC FAMILY MEDICINE
Mailing Address - City:MCKEESPORT
Mailing Address - State:PA
Mailing Address - Zip Code:15132-1126
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2347 FIFTH AVE
Practice Address - Street 2:UPMC FAMILY MEDICINE
Practice Address - City:MCKEESPORT
Practice Address - State:PA
Practice Address - Zip Code:15132-1126
Practice Address - Country:US
Practice Address - Phone:412-673-5009
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-11
Last Update Date:2021-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD422632207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0019733050003Medicaid
PA075392J56Medicare ID - Type Unspecified
PA0019733050003Medicaid