Provider Demographics
NPI:1811339161
Name:ALSHURBAJI, EHAB (MD)
Entity type:Individual
Prefix:
First Name:EHAB
Middle Name:
Last Name:ALSHURBAJI
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 1:2500 W 12TH ST STE C
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16505-4500
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2500 W 12TH ST STE C
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16505-4500
Practice Address - Country:US
Practice Address - Phone:814-877-6317
Practice Address - Fax:814-877-2844
Is Sole Proprietor?:No
Enumeration Date:2013-07-26
Last Update Date:2025-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN74318207RP1001X, 207RC0200X
CAA164151207R00000X
GA95186207RP1001X
IN01078037A208M00000X, 207R00000X
PAMD489377C207RP1001X
MDAP22784393106207R00000X
OH35.130614208M00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0210561Medicaid
IN300000898Medicaid
IN300000898Medicaid