Provider Demographics
NPI:1538053442
Name:SHOKR, MOHAMED
Entity type:Individual
Prefix:MR
First Name:MOHAMED
Middle Name:
Last Name:SHOKR
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 1:2281 KEW GARDENS DR
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22191-6601
Mailing Address - Country:US
Mailing Address - Phone:703-606-9229
Mailing Address - Fax:
Practice Address - Street 1:13285 MINNIEVILLE RD
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22192-4018
Practice Address - Country:US
Practice Address - Phone:800-777-7904
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-05
Last Update Date:2025-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCRN500008566163W00000X
IL041511070163W00000X
NY870441163W00000X
CA95329702163W00000X
VA0001311285163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse