Individual
MOHAMMED FADLALLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
234 GOODMAN STREET, CINCINNATI, OH 45219-2364
(513) 584-4503
Mailing address
PO BOX 636256, CENTRAL CREDENTIALING, CINCINNATI, OH 45263-6256
(513) 585-5504
(513) 585-5511
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
35126843
OH
Other
Enumeration date
05/04/2011
Last updated
08/08/2017
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