Individual
DR. FATUMA MIDAMBA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3619 PARK EAST DR, 205 S., BEACHWOOD, OH 44122-4330
(216) 591-0942
(440) 591-0943
Mailing address
PO BOX 24160, LYNDHURST, OH 44124-0160
(216) 233-2527
(216) 591-0943
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
BM5763986
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0860278
MEDICARE
OH
05
—
2073572
—
OH
Enumeration date
01/25/2006
Last updated
03/17/2010
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