Provider Demographics
NPI:1285881201
Name:SHEQWARA, JAWAD (MD)
Entity type:Individual
Prefix:DR
First Name:JAWAD
Middle Name:
Last Name:SHEQWARA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1900 TEBEAU ST
Mailing Address - Street 2:
Mailing Address - City:WAYCROSS
Mailing Address - State:GA
Mailing Address - Zip Code:31501-6357
Mailing Address - Country:US
Mailing Address - Phone:912-490-4673
Mailing Address - Fax:912-490-4674
Practice Address - Street 1:1706 ALICE ST
Practice Address - Street 2:
Practice Address - City:WAYCROSS
Practice Address - State:GA
Practice Address - Zip Code:31501-5216
Practice Address - Country:US
Practice Address - Phone:912-490-4673
Practice Address - Fax:912-490-4674
Is Sole Proprietor?:No
Enumeration Date:2008-08-20
Last Update Date:2014-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301092099207R00000X
GA071285207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine