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Individual

DR. EMAD SABRY SHAFIEK GRACE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D

Contact information

Practice address
301 MEMORIAL MEDICAL PKWY, DAYTONA BEACH, FL 32117-5167
(386) 231-1091
Mailing address
PO BOX 935921, ATLANTA, GA 31193-5921

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
2008-01432
NC
207R00000X
Internal Medicine Physician
Primary
ME171040
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
151NM
BCBSNC
NC
05
305501
SC
05
5911132
NC
Enumeration date
06/14/2007
Last updated
02/21/2025
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