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Individual

MAZIN SHACKOUR

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1330 MERCY DR NW, SUITE 420, CANTON, OH 44708-2626
(330) 580-4697
(330) 588-4698
Mailing address
2665 WINGATE WAY NW, APT 4, CANTON, OH 44708-8945

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
036171144
IL
208600000X
Surgery Physician
Primary
35120787
OH
2086S0102X
Surgical Critical Care Physician
036171144
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0084650
OH
Enumeration date
12/31/2007
Last updated
08/18/2025
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