1992880405 NPI number — NAJIB MAWAD R.PH.

Table of content: NAJIB MAWAD R.PH. (NPI 1992880405)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1992880405 NPI number — NAJIB MAWAD R.PH.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MAWAD
Provider First Name:
NAJIB
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
R.PH.
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:
1992880405
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/20/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8046 NEBRASKA AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
TOLEDO
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
43617-2010
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
419-450-9778
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1627 HENTHORNE DR STE A
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MAUMEE
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
43537-1370
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
419-214-4600
Provider Business Practice Location Address Fax Number:
419-214-4601
Provider Enumeration Date:
10/25/2006

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: 183500000X , with the licence number:  03120929 , 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: 147147147147 . This is a "03120929" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".




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