Individual
DR. HAITHAM J KOUSA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
9485 MENTOR AVE STE 104, MENTOR, OH 44060-8722
(440) 205-5770
(440) 205-7202
Mailing address
9485 MENTOR AVE, SUITE 104, MENTOR, OH 44060-4597
(440) 205-5770
(440) 205-7202
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
60918
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0919911
—
OH
Enumeration date
08/06/2006
Last updated
10/15/2016
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