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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

WISAM FAWZI SHABA, M.D

Active

WISAM FAWZI SHABA, M.D is a Nuclear Medicine healthcare provider located in SURPRISE, Arizona. NPI 1366712176 is currently active in the NPPES registry. Verify at CMS.

Nuclear Medicine · SURPRISE, AZ

Registration Details

NPI Number
1366712176
Provider Type
Individual
Gender
Male
NPI Issued
Jan 10, 2012 (14.614010613651 yrs)
Last Updated
Mar 30, 2022
Licenses
A117646 (CA)
A117646 (CA)
50677 (AZ)

Practice Information

Address
14775 W YORKSHIRE DR
SURPRISE, AZ, 853747224
Browse AZ providers · Browse ZIP 85374
Phone
6235945050
Primary Specialty
Nuclear Medicine
207U00000X
Additional Specialty
Diagnostic Radiology
Additional Specialty
Nuclear Medicine
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.