Provider Demographics
NPI:1730197104
Name:SHAWKY A HASSAN MD PHD PA
Entity type:Organization
Organization Name:SHAWKY A HASSAN MD PHD PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SHAWKY
Authorized Official - Middle Name:A
Authorized Official - Last Name:HASSAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD PHD
Authorized Official - Phone:239-261-5599
Mailing Address - Street 1:680 2ND AVE N STE 201
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34102-5758
Mailing Address - Country:US
Mailing Address - Phone:239-261-5599
Mailing Address - Fax:239-261-6643
Practice Address - Street 1:680 2ND AVE N STE 201
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34102-5758
Practice Address - Country:US
Practice Address - Phone:239-261-5599
Practice Address - Fax:239-261-6643
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-03
Last Update Date:2021-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK1343Medicare PIN