Individual
NIDAL CHOUJAA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
2600 6TH ST SW, CANTON, OH 44710
(330) 363-6223
(330) 363-3877
Mailing address
PO BOX 80690, CANTON, OH 44708-0690
(330) 363-7444
(330) 363-7770
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
34.016690
OH
2255A2300X
Athletic Trainer
—
—
390200000X
Student in an Organized Health Care Education/Training Program
58.030923
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2000018677
BOARD OF CERTIFICATION FOR THE ATHLETIC TRAINER
—
Enumeration date
08/28/2014
Last updated
07/12/2023
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