Individual
AMANDA SHOUBAKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
1002 JEFFERSON STREET, SUITE 200, LAUREL, MS 39441-0247
(601) 649-3520
(601) 399-6184
Mailing address
PO BOX 247, LAUREL, MS 39441-0247
(601) 425-7550
(601) 399-6184
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
28564
MS
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/30/2018
Last updated
08/16/2021
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