Provider Demographics
NPI:1053753442
Name:WAHBA, NASHWA MARIE (DO)
Entity type:Individual
Prefix:DR
First Name:NASHWA
Middle Name:MARIE
Last Name:WAHBA
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:810 WILDWOOD ST.
Mailing Address - Street 2:SUITE 1
Mailing Address - City:DAYTONA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32117
Mailing Address - Country:US
Mailing Address - Phone:386-258-7100
Mailing Address - Fax:386-253-1843
Practice Address - Street 1:810 WILDWOOD ST
Practice Address - Street 2:SUITE 1
Practice Address - City:DAYTONA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32117
Practice Address - Country:US
Practice Address - Phone:386-258-7100
Practice Address - Fax:386-253-1843
Is Sole Proprietor?:No
Enumeration Date:2013-07-25
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLUO3519207R00000X
FLOS14022208M00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist