1750697702 NPI number — RANA SHAHAB M.D., FAAD

Table of content: RANA SHAHAB M.D., FAAD (NPI 1750697702)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1750697702 NPI number — RANA SHAHAB M.D., FAAD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SHAHAB
Provider First Name:
RANA
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D., FAAD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1750697702
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/29/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
POBOX 9827
Provider Second Line Business Mailing Address:
SAUDI ARAMCO
Provider Business Mailing Address City Name:
DHAHRAN
Provider Business Mailing Address State Name:
EASTERN
Provider Business Mailing Address Postal Code:
31311
Provider Business Mailing Address Country Code:
SA
Provider Business Mailing Address Telephone Number:
966505819669
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
DHAHRAN HEALTH CENTER ROOM 428-5 BUIDLING 61
Provider Second Line Business Practice Location Address:
SAUDI ARAMCO
Provider Business Practice Location Address City Name:
DHAHRAN
Provider Business Practice Location Address State Name:
EASTERN
Provider Business Practice Location Address Postal Code:
31311
Provider Business Practice Location Address Country Code:
SA
Provider Business Practice Location Address Telephone Number:
966505819669
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/28/2010

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207N00000X , with the licence number:  04-K-M-2679 , registered in the state of ZZ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)