Healthcare Provider Details

I. General information

NPI: 1144501594
Provider Name (Legal Business Name): SAFWAN KHADER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/30/2011
Last Update Date: 04/06/2025
Certification Date: 04/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

525 E MARKET ST
AKRON OH
44304-1619
US

IV. Provider business mailing address

35557 BENTLEY DR
AVON OH
44011-3811
US

V. Phone/Fax

Practice location:
  • Phone: 330-253-8195
  • Fax:
Mailing address:
  • Phone: 440-570-6836
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number35.123014
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number57.019044
License Number StateOH
# 3
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number57.019044
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: