Individual
DR. OMAR FATTAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D., M.P.H.
Contact information
Practice address
1730 W 25TH ST, SUITE 2A, CLEVELAND, OH 44113-3108
(216) 363-2304
(216) 363-2356
Mailing address
1730 W 25TH ST, SUITE 2A, CLEVELAND, OH 44113-3108
(216) 363-2304
(216) 363-2356
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
35084934
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000368726
ANTHEM
OH
05
—
2580167
—
OH
Enumeration date
09/27/2005
Last updated
11/09/2009
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