Provider Demographics
NPI:1871060608
Name:SHAHATA, AHMED F (MD)
Entity type:Individual
Prefix:DR
First Name:AHMED
Middle Name:F
Last Name:SHAHATA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:100 N ACADEMY AVE
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17822-4903
Mailing Address - Country:US
Mailing Address - Phone:570-808-7916
Mailing Address - Fax:570-808-6006
Practice Address - Street 1:1155 EAST MTN BLVD
Practice Address - Street 2:
Practice Address - City:WILKES BARRE
Practice Address - State:PA
Practice Address - Zip Code:18702-7906
Practice Address - Country:US
Practice Address - Phone:570-808-7916
Practice Address - Fax:570-808-6006
Is Sole Proprietor?:No
Enumeration Date:2018-10-30
Last Update Date:2025-11-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD472659207V00000X
OH35.135087207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH35.135087OtherOHIO ELICENSE