Individual
DR. MOURHAF TRABOULSSI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
703 TYLER ST, SUITE 250, SANDUSKY, OH 44870-3367
(440) 414-9300
(216) 201-5588
Mailing address
703 TYLER ST STE 250, SANDUSKY, OH 44870-3390
(440) 414-9300
(216) 201-5588
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
35073562
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000128699
ANTHEM
OH
01
—
060047442
RAILROAD MEDICARE
—
01
—
100413
KAISER
OH
01
—
341221800083
CARESOURCE
OH
01
—
E73562
SUMMACARE
OH
Enumeration date
01/16/2006
Last updated
01/07/2021
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