Individual
MR. AWNI DARWEESH SHAHAIT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
305 W JACKSON ST STE 206, CARBONDALE, IL 62901-1474
(618) 457-3006
(618) 457-3007
Mailing address
PO BOX 3988, CARBONDALE, IL 62902-3988
(618) 457-5200
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
036160126
IL
2086S0102X
Surgical Critical Care Physician
036160126
IL
2086S0127X
Trauma Surgery Physician
Primary
036160126
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/28/2015
Last updated
02/10/2025
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