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NPI Code Detail

MEDICARE: HEBA ALLAM OD

MEDICARE:   HEBA  ALLAM  OD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training Program
2152W00000XOptometristOPT.007331OH

General Provider Information

NPI Number : 1548008923
Entity Type Code : Individual
Provider Name (Legal Business Name) : HEBA ALLAM OD
Provider Business Mailing Address
First Line : 7817 KENWOOD RD
Second Line :
City : CINCINNATI
State : OH
Zip : 45236-2805
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 7817 KENWOOD RD
Second Line :
City : CINCINNATI
State : OH
Zip : 45236-2805
Country : US
Telephone Number : 859-536-2485
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/18/2024
Last Update Date : 11/27/2024

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Directions to “ HEBA ALLAM OD” Practice Location

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