Basic Information
| Provider Information | |||||||||
| NPI: | 1437539129 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ALSHEBEEB | ||||||||
| FirstName: | KUTAIBA | ||||||||
| MiddleName: | TAHA HAMID | ||||||||
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| Mailing Information | |||||||||
| Address1: | 644 OVINGTON AVE | ||||||||
| Address2: | FLOOR 2 | ||||||||
| City: | BROOKLYN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 112091658 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5042228535 | ||||||||
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| Practice Location | |||||||||
| Address1: | 601 N CAROLINE ST FL 2 | ||||||||
| Address2: | |||||||||
| City: | BALTIMORE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 212870006 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4109555000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/08/2015 | ||||||||
| LastUpdateDate: | 07/27/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 07/27/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 2085R0202X | D91291 | MD | Y | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology |
No ID Information.