Individual
DR. TAREK SHAABAN MOUSTAFA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2658 W. LASKEY ROAD, 2ND FLOOR, TOLEDO, OH 43613-3288
(419) 473-8105
(419) 254-2121
Mailing address
3455 MILL RUN DRIVE, SUITE 405, HILLIARD, OH 43026-9083
(614) 771-2222
(614) 771-2221
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
4301083897
MI
2085R0204X
Vascular & Interventional Radiology Physician
4301083897
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2590941
—
OH
05
—
4766161
—
MI
Enumeration date
10/13/2006
Last updated
03/25/2010
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