Individual
DR. FATHALLAH HAYEK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6270 N RIDGE RD, MADISON, OH 44057-2567
(440) 428-6800
(440) 255-3637
Mailing address
36000 EUCLID AVE # MSO, WILLOUGHBY, OH 44094-4625
(440) 953-6082
(440) 953-6101
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
35-053400
OH
207Q00000X
Family Medicine Physician
Primary
35-053400
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000339404
ANTHEM
OH
05
—
0623043
—
OH
01
—
264200002
FEDERAL BLACK LUNG
OH
01
—
341425870040
MEDICAL MUTUAL OF OHIO
OH
01
—
6600162
UNITED HEALTHCARE
OH
01
—
80507
QUALCHOICE
OH
01
—
H059041
MEDICARE
OH
Enumeration date
03/24/2006
Last updated
05/06/2021
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