Individual
DR. CHADI ELIAS BOU SERHAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D., M.S.
Contact information
Practice address
2600 TUSCARAWAS ST W, SUITE 100, CANTON, OH 44708-4644
(330) 452-8844
(330) 452-7012
Mailing address
2600 TUSCARAWAS ST W, SUITE 100, CANTON, OH 44708-4644
(330) 452-8844
(330) 452-7012
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
35.086682
OH
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
35-086682
OH
207RP1001X
Pulmonary Disease Physician
35-086682
OH
207RS0012X
Sleep Medicine (Internal Medicine) Physician
35-086682
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2750321
—
OH
01
—
35.086682
OHIO LICENSE NUMBER
OH
Enumeration date
02/21/2007
Last updated
01/18/2011
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