Individual
MENNATALLAH OMAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
501 VAN BUREN ST STE 203, FOSTORIA, OH 44830-1593
(419) 355-8488
(419) 355-8490
Mailing address
2281 HAYES AVE, FREMONT, OH 43420-2632
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
35144594
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0498909
—
OH
Enumeration date
06/28/2015
Last updated
11/03/2023
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