1235192311 NPI number — FEYROUZ T AL-ASHKAR M. D.

Table of content: FEYROUZ T AL-ASHKAR M. D. (NPI 1235192311)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1235192311 NPI number — FEYROUZ T AL-ASHKAR M. D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
AL-ASHKAR
Provider First Name:
FEYROUZ
Provider Middle Name:
T
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M. D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
ALASHKAR
Provider Other First Name:
FEYROUZ
Provider Other Middle Name:
T
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
M.D.
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1235192311
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/19/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6801 BRECKSVILLE RD STE 20
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
INDEPENDENCE
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
44131-5062
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
216-444-2200
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9500 EUCLID AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CLEVELAND
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
44195-0001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
800-223-2273
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/10/2006

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: 207RR0500X , with the licence number:  35087346 , 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: P00301775 . This is a "MEDICARE RAILROAD" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 2629178 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".