Provider Demographics
NPI:1508749466
Name:ABUHASHEM, SHADI ISSA AHMAD (MBBCH)
Entity type:Individual
Prefix:MR
First Name:SHADI
Middle Name:ISSA AHMAD
Last Name:ABUHASHEM
Suffix:
Gender:M
Credentials:MBBCH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:ECMC-OFFICE OF MEDICAL EDUCATION
Mailing Address - Street 2:462 GRIDER ST
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14215
Mailing Address - Country:US
Mailing Address - Phone:716-898-4578
Mailing Address - Fax:716-898-3279
Practice Address - Street 1:ECMC-OFFICE OF MEDICAL EDUCATION
Practice Address - Street 2:462 GRIDER ST
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14215
Practice Address - Country:US
Practice Address - Phone:716-898-4578
Practice Address - Fax:716-898-3279
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-29
Last Update Date:2025-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program