Organization
PREMIER DOCTORS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. M. HAZEM NOURALDIN MD (PHYSICIAN PARTNER)
(216) 522-9100
Entity
Organization
Contact information
Practice address
1730 W 25TH ST, CLEVELAND, OH 44113-3108
(216) 522-9100
Mailing address
PO BOX 45001, WESTLAKE, OH 44145-0001
(216) 522-9100
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
207RP1001X
Pulmonary Disease Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4238504
STATE OF OHIO BUSINESS CERTIFICATE
OH
Enumeration date
11/28/2018
Last updated
11/28/2018
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