Organization
PROFESSIONAL CLINICAL SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AHMED E MOSTAFA MD (PRESIDENT)
(513) 377-7189
Entity
Organization
Contact information
Practice address
1010 CEREAL AVE, SUITE 100, HAMILTON, OH 45013-2784
(513) 867-2057
Mailing address
PO BOX 93, MASON, OH 45040-0093
(513) 377-7189
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2847665
—
OH
Enumeration date
05/01/2008
Last updated
09/11/2008
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