Issam Mahmoud Shebaro, MD

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

0101045171 Issued in VA

Practice address

11445 Sunset Hills Road
Reston, VA 20190-5276

Phone

(703) 709-1500

Fax

(703) 709-1711

NPI assigned

Dec 4, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1165190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321574400000",
    "number": "1023176013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2101 E JEFFERSON ST PPQA MEDICARE COMPLIANCE UNIT 6 W",
            "address_2": "KAISER PERMANENTE MIDATLANTIC PERMANENTE MEDICAL GRP PC",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208524908",
            "telephone_number": "301-816-2424",
            "fax_number": "301-816-6308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11445 SUNSET HILLS ROAD",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201905276",
            "telephone_number": "703-709-1500",
            "fax_number": "703-709-1711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEBARO",
        "first_name": "ISSAM",
        "middle_name": "MAHMOUD",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-04",
        "last_updated": "2011-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "VA",
            "license": "0101045171",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sumit Sharma, D.D.S.
• Fatima Shaukat
• Elaine Marie Shaver, LCSW
• Timothy Roddy Shaver, MD
• Eric L Shea, DO
• Katie Shen, DNP, NP
• Nancy Ruth Sherwood, BA, IBCLC
• Devin Moore Shiple
• Mohammad Farhaj Shirazi, M.D.
• Robert A. Shor, M.D.

• Obstetrics & Gynecology Physician in Reston, VA
• Providers in Reston, VA by specialty
• Obstetrics & Gynecology Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.