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Individual

MOURAD L ROSTOM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
310 WINDSOR DR, CORTLAND, OH 44410-2705
(330) 675-4450
(330) 675-4451
Mailing address
310 WINDSOR DR, CORTLAND, OH 44410-2705
(330) 675-4450
(330) 675-4451

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
35061163
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000243198
ANTHEM BC/BS
OH
01
000720761
HIGHMARK BC/BS PA
OH
05
0855552
OH
01
110247872
RAILROAD MEDICARE
OH
01
341341025028
CARESOURCE
OH
01
400887
UNITED HEALTHCARE
OH
01
78911
HEALTH ASSURANCE
OH
01
J61163
SUMMACARE
OH
01
Q025272
HOMETOWN
OH
Enumeration date
07/03/2006
Last updated
09/15/2023
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