Individual
KHADER MUSTAFA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
5700 MONROE ST UNIT 202, SYLVANIA, OH 43560
(567) 585-0115
Mailing address
5700 MONROE ST UNIT 202, SYLVANIA, OH 43560-2735
(567) 585-0115
Taxonomy
Speciality
Code
Description
License number
State
207RR0500X
Rheumatology Physician
Primary
35063837
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0892673
—
OH
Enumeration date
07/13/2015
Last updated
01/22/2019
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