Individual
OMAR MOHAMED ELSHAZLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1120 15TH ST, AUGUSTA, GA 30912-2335
(706) 721-8623
Mailing address
1120 15TH ST # OR6000, AUGUSTA, GA 30912-0004
(706) 721-3813
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
288883
MA
2086S0129X
Vascular Surgery Physician
Primary
97337
GA
390200000X
Student in an Organized Health Care Education/Training Program
4301113197
MI
Other
Enumeration date
08/30/2015
Last updated
10/10/2023
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