Individual
BASEL ALTAQI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6707 POWERS BLVD, SUITE 106, PARMA, OH 44129-5455
(440) 886-2509
(440) 886-2547
Mailing address
6707 POWERS BLVD, SUITE 106, PARMA, OH 44129-5455
(440) 886-2509
(440) 886-2547
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
35085185
OH
207RP1001X
Pulmonary Disease Physician
Primary
35085185
OH
208M00000X
Hospitalist Physician
35085185
OH
208M00000X
Hospitalist Physician
39320
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000362550
BCBS PROVIDER NUMBER
KY
05
—
3147795
—
OH
01
—
39320
KENTUCKY MEDICAL LICENSE
KY
05
—
64097439
—
KY
Enumeration date
06/02/2006
Last updated
02/26/2025
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