Individual
DR. KHALED M SHAMMOUT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1600 SW ARCHER ROAD, M-509, GAINESVILLE, FL 32610-0254
(352) 265-0486
(352) 265-1062
Mailing address
1600 SW ARCHER ROAD, M-509, GAINESVILLE, FL 32610-0254
(352) 265-0486
(352) 265-1062
Taxonomy
Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
Primary
4301073067
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1106314852
BCBSM
MI
05
—
4714307
—
MI
Enumeration date
08/01/2006
Last updated
08/09/2007
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