Provider Demographics
NPI:1871947515
Name:EL-ATOUM, MOHAMMAD SHAFIQ AHMAD (MD)
Entity type:Individual
Prefix:
First Name:MOHAMMAD
Middle Name:SHAFIQ AHMAD
Last Name:EL-ATOUM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:462 GRIDER ST
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14215
Mailing Address - Country:US
Mailing Address - Phone:716-898-4806
Mailing Address - Fax:716-898-3279
Practice Address - Street 1:100 HIGH ST STE B6
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14203-1126
Practice Address - Country:US
Practice Address - Phone:716-859-4211
Practice Address - Fax:716-859-4208
Is Sole Proprietor?:No
Enumeration Date:2016-04-19
Last Update Date:2024-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
IL036154974207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program