Provider Demographics
NPI:1801969985
Name:SHAHEEN, ADEL M (MD)
Entity type:Individual
Prefix:
First Name:ADEL
Middle Name:M
Last Name:SHAHEEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1298
Mailing Address - Street 2:770 W HIGH ST SUITE 370
Mailing Address - City:LIMA
Mailing Address - State:OH
Mailing Address - Zip Code:45802
Mailing Address - Country:US
Mailing Address - Phone:419-222-0189
Mailing Address - Fax:419-225-8691
Practice Address - Street 1:770 W HIGH ST STE 210
Practice Address - Street 2:
Practice Address - City:LIMA
Practice Address - State:OH
Practice Address - Zip Code:45801-5902
Practice Address - Country:US
Practice Address - Phone:419-222-0189
Practice Address - Fax:419-225-8691
Is Sole Proprietor?:No
Enumeration Date:2006-11-16
Last Update Date:2022-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35057167207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0826226Medicaid
E92278Medicare UPIN
OHSH4096995Medicare PIN
OHSH4096994Medicare PIN
OHE92279Medicare UPIN
OH9339883Medicare PIN
OH0826226Medicaid