1841281797 NPI number — DR. BADI ALTAWIL MD

Table of content: DR. BADI ALTAWIL MD (NPI 1841281797)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1841281797 NPI number — DR. BADI ALTAWIL MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ALTAWIL
Provider First Name:
BADI
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1841281797
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/10/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
100 DEBARTOLO PL STE 200
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
YOUNGSTOWN
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
44512-6095
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
330-729-8146
Provider Business Mailing Address Fax Number:
330-965-5229

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4439 MAHONING AVE NW STE A
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WARREN
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
44483-1975
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
330-847-6527
Provider Business Practice Location Address Fax Number:
330-847-6572
Provider Enumeration Date:
10/31/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , with the licence number:  35.072864 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 2137842 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com