1083812101 NPI number — OMAR ZMEILI MD

Table of content: OMAR ZMEILI MD (NPI 1083812101)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1083812101 NPI number — OMAR ZMEILI MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ZMEILI
Provider First Name:
OMAR
Provider Middle Name:
Provider Name Prefix Text:
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:
1083812101
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/23/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
168 E MARKET ST
Provider Second Line Business Mailing Address:
PO BOX 3542
Provider Business Mailing Address City Name:
AKRON
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
44308-2038
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
330-996-0347
Provider Business Mailing Address Fax Number:
330-996-0359

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
75 ARCH ST
Provider Second Line Business Practice Location Address:
301
Provider Business Practice Location Address City Name:
AKRON
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
44304-1429
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
330-253-1899
Provider Business Practice Location Address Fax Number:
330-253-2108
Provider Enumeration Date:
07/10/2007

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: 207RE0101X , with the licence number:  35120469 , 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)





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