Individual
ABDEL FARID ABU SHAMAT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
333 DR MICHAEL DEBAKEY DR, SUITE 140, LAKE CHARLES, LA 70601-5887
(337) 494-7090
(337) 494-7040
Mailing address
333 DR MICHAEL DEBAKEY DR, SUITE 140, LAKE CHARLES, LA 70601-5887
(337) 494-7090
(337) 494-7040
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
11617R
LA
207RN0300X
Nephrology Physician
Primary
11617R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1679232
—
LA
01
—
P00103040
RR MEDICARE
LA
Enumeration date
09/13/2005
Last updated
11/17/2009
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