Wisam Fawzi Shaba, MD
Wisam Fawzi Shaba, MD is a Nuclear Medicine in Surprise, Arizona. Qualified in 1999, 27 years ago. Practices with Alante Primary Care W LLC, a 4-clinician group and accepts Medicare assignment. Licensed in Arizona and California.
- Years since qualifying
- 27
- Licensed in
- AZ, CA
- In the registry since
- 2012
- Specialties on file
- 3
What do these letters mean?
- MD — Doctor of Medicine
- A physician who completed allopathic medical school.
Practice location Address checks out
14775 W Yorkshire DrSurprise, AZ 85374-7224
Phone: (623) 594-5050
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Nuclear Medicine Physician (primary) | Taxonomy 207U00000X · Licence 50677 (AZ) |
|---|---|
| Nuclear Medicine Physician | Taxonomy 207U00000X · Licence A117646 (CA) |
| Diagnostic Radiology Physician | Taxonomy 2085R0202X · Licence A117646 (CA) |
Record details
| NPI number | 1366712176 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Credentials | MD |
| Sole proprietor | No |
| NPI enumerated | January 10, 2012 |
| Last updated in NPPES | March 30, 2022 |
| Certification date | March 30, 2022 |
Medicare enrollment
| Medicare specialty | NUCLEAR MEDICINE |
|---|---|
| Medical school | OTHER |
| Graduated | 1999 (27 years in practice) |
| Group practice | Alante Primary Care W Llc — 4 clinicians |
| Accepts Medicare assignment | Yes — accepts the Medicare-approved amount |
| Practice locations | 3 on file with Medicare |