Individual
MIKHAEL T. ABOURJEILY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
8655 MARKET STREET, MENTOR, OH 44060
(440) 255-6400
(440) 255-3637
Mailing address
5700 DARROW RD, SUITE 106, HUDSON, OH 44236-5021
(330) 656-5911
(330) 656-5901
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
34005104A
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000383091
ANTHEM
OH
01
—
001822820-0001
PENNSYLVANIA MEDICAID
OH
05
—
0848631
—
OH
Enumeration date
12/14/2005
Last updated
08/19/2022
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