Provider Demographics
NPI:1487741070
Name:SHALHUB, DON S (MD)
Entity type:Individual
Prefix:
First Name:DON
Middle Name:S
Last Name:SHALHUB
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 1:7100 W. 20TH AVENUE
Mailing Address - Street 2:S. 414
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33016
Mailing Address - Country:US
Mailing Address - Phone:305-557-3311
Mailing Address - Fax:305-444-3530
Practice Address - Street 1:7100 W. 20TH AVENUE
Practice Address - Street 2:S. 414
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33016
Practice Address - Country:US
Practice Address - Phone:305-557-3311
Practice Address - Fax:305-444-3530
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-06
Last Update Date:2023-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 23235207NS0135X
FLME23235207NS0135X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural DermatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
D58508Medicare UPIN
D58508Medicare UPIN