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NPI Lookup from the NPI Registry — National Provider Identifier Database

Contact Information

WISSAM M SHAYA, MD
1907 ATLANTIC BLVD
JACKSONVILLE, FL32207-3466
 Phone: 904-388-4712
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Family Medicine

207Q00000X 08 Physician/Family Practice
Indicates primary specialty

NPI Profile & details for WISSAM M SHAYA · (Male)

NPI # 1003010349
Status Active
Credentials MD
Entity Individual
Enumeration date 06/12/2007
Last updated 06/09/2015 - About 4 years ago
Sole proprietor 1 No
Identifiers
  • MI License # 4301082473
  • MI Other 4301082473 STATE LICENSE
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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