# BADR K. GHUMRAWI, M.D. INC.

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

## Provider details

- **NPI number:** 1639356116
- **Authorized official:** BADR K GHUMRAWI MD (PRESIDENT, OWNER)
- **Authorized official phone:** (330) 296-2829

## Contact information

- **Practice address:** 6693 N CHESTNUT ST, SUITE 268A, RAVENNA, OH 44266-3922
- **Practice address phone:** (330) 296-2829
- **Practice address fax:** (330) 296-7202
- **Mailing address:** 6693 N CHESTNUT ST, SUITE 268A, RAVENNA, OH 44266-3922
- **Mailing address phone:** (330) 296-2829
- **Mailing address fax:** (330) 296-7202

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208600000X | Surgery Physician | 35036836 | OH | — |
| 2086S0129X | Vascular Surgery Physician | 35036836 | OH | — |
| 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | 35036836 | OH | Yes |

## Other

- **Enumeration date:** 01/27/2008
- **Last updated:** 09/09/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 000000129043 | ANTHEM | — |
| 05 | — | 0231538 | — | OH |
| 01 | — | 099507636 | WORKERS COMPENSATION | — |
| 01 | — | 100430 | KAISER | — |
| 01 | — | 27174 | NATIONWIDE | — |
| 01 | — | 4132029 | AETNA | — |
| 01 | — | 71479 | QUALCHOICE | — |