Individual
MOHAMMED IBRAHIM SHAKHATREH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
1925 PACIFIC AVE, ATLANTIC CITY, NJ 08401-6713
(609) 652-1000
Mailing address
475 SEAVIEW AVE, STATEN ISLAND, NY 10305-3436
(718) 226-9000
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD.207078
LA
207RG0100X
Gastroenterology Physician
Primary
25MA10215000
NJ
207RG0100X
Gastroenterology Physician
314288
NY
207RG0100X
Gastroenterology Physician
MD462390
PA
208M00000X
Hospitalist Physician
R1291
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
404357201
—
TX
01
—
H08LV56001
BCBS-TEXAS
TX
Enumeration date
09/01/2011
Last updated
04/02/2026
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