Healthcare Provider Details

I. General information

NPI: 1326979063
Provider Name (Legal Business Name): ABDULLAH AL NEDAWI
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/28/2026
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22901 MILL CREEK DR STE 200
BEACHWOOD OH
44122
US

IV. Provider business mailing address

1218 ROBBINS RUN CT
DAYTON OH
45458-1955
US

V. Phone/Fax

Practice location:
  • Phone: 216-727-0234
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberRES.005101
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: