Basic Information
| Provider Information | |||||||||
| NPI: | 1952532350 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SHOIB | ||||||||
| FirstName: | MAHMOUD | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 11900 NE 18TH ST | ||||||||
| Address2: | APT # 79 | ||||||||
| City: | VANCOUVER | ||||||||
| State: | WA | ||||||||
| PostalCode: | 986844886 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8146191626 | ||||||||
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| Practice Location | |||||||||
| Address1: | 400 NE MOTHER JOSEPH PL | ||||||||
| Address2: | COGENT HMG | ||||||||
| City: | VANCOUVER | ||||||||
| State: | WA | ||||||||
| PostalCode: | 986643200 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3605143727 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/03/2009 | ||||||||
| LastUpdateDate: | 10/03/2017 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | MT194540 | PA | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | MD446240 | PA | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | MD.MD.60347966 | WA | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | A137487 | CA | N | Allopathic & Osteopathic Physicians | Internal Medicine | 208M00000X | A137487 | CA | Y | Allopathic & Osteopathic Physicians | Hospitalist |
No ID Information.