Shamsham, Fadi Michel
Shamsham, Fadi Michel is an individual health care provider with primary practice located at 4115 S. Water Tower Place , Mt. Vernon IL 62864. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Cardiovascular Disease, Allopathic & Osteopathic Physicians / Interventional Cardiology. Allopathic & Osteopathic Physicians / Interventional Cardiology is his primary health care specialty. Shamsham, Fadi Michel can be contacted via phone (618) 204-5462.Contact Information
Primary practice address
4115 S. Water Tower Place
Mt. Vernon IL 62864
Phone: (618) 204-5462
Fax: (618) 204-5472
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 036123701 | Illinois |
| Allopathic & Osteopathic Physicians / Cardiovascular Disease | 207RC0000X | 036123701 | Illinois |
| Allopathic & Osteopathic Physicians / Interventional Cardiology | 207RI0011X | 036123701 | Illinois |
Profile Details
| NPI number | 1942203971 |
|---|---|
| LBN Legal business name | Shamsham, Fadi Michel |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 23rd, 2005 |
| Last updated | Apr 19th, 2010 - about 14 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1942203971 | NPPES |
| Illinois | MEDICAID | 036123701 |
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