Individual
MAZEN DAHBAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5172 LEAVITT RD, LORAIN, OH 44053
(440) 282-7420
(440) 282-9855
Mailing address
5334 MEADOW LANE COURT, SHEFFIELD VILLAGE, OH 44035-1469
(440) 934-5454
(440) 934-8999
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
35.098499
OH
207R00000X
Internal Medicine Physician
42810
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000626825
ANTHEM BC/BS
KY
01
—
11976463
CAQH
—
05
—
31-001050
—
KY
05
—
7100105590
—
KY
Enumeration date
06/05/2007
Last updated
05/30/2012
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