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Individual

FADI S BASHOUR

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
7575 NORTHCLIFF AVE, SUITE 302, BROOKLYN, OH 44144-3267
(216) 398-5988
(216) 398-5832
Mailing address
7575 NORTHCLIFF AVE, SUITE 302, BROOKLYN, OH 44144-3267
(216) 398-5988
(216) 398-5832

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
35065516
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000215837
ANTHEM BC/BS
OH
05
0940512
OH
01
160056024
RAILROAD CARE
OH
01
350267
WELLCARE
OH
01
P00705906
RRCARE
OH
Enumeration date
05/09/2006
Last updated
10/26/2011
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