# AHMAD BANNA, M.D., LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1144469388
- **Authorized official:** DR. AHMAD BANNA MD (PRESIDENT)
- **Authorized official phone:** (440) 352-4956

## Contact information

- **Practice address:** 124 LIBERTY ST, PAINESVILLE, OH 44077-3303
- **Practice address phone:** (440) 352-4956
- **Practice address fax:** (440) 352-0397
- **Mailing address:** 124 LIBERTY ST, PAINESVILLE, OH 44077-3303
- **Mailing address phone:** (440) 352-4956
- **Mailing address fax:** (440) 352-0397

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | 35045031 | OH | Yes |

## Other

- **Enumeration date:** 02/11/2009
- **Last updated:** 02/11/2009