Individual
MOHAMED NISAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3540 RIDGE RD, CLEVELAND, OH 44102-5444
(216) 226-0692
Mailing address
3540 RIDGE RD, CLEVELAND, OH 44102-5444
(216) 226-0692
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
35040140
OH
207RA0401X
Addiction Medicine (Internal Medicine) Physician
35040140
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
OH
Enumeration date
03/08/2006
Last updated
10/13/2017
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