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Individual

AHMAD BASSEL SHUGHOURY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
8895 BROADWAY, MERRILLVILLE, IN 46410-7037
(219) 738-2081
(219) 736-4658
Mailing address
8558 BROADWAY, MERRILLVILLE, IN 46410-7032
(219) 392-7084
(219) 703-6854

Taxonomy

Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
01059363A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000346359
ANTHEM BC/BS
IN
05
200108230A
IN
01
9115389
ANTHEM BC/BS
IN
01
P00204531
RAILROAD MEDICARE
IN
Enumeration date
06/01/2005
Last updated
05/05/2020
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