Healthcare Provider Details

I. General information

NPI: 1275701450
Provider Name (Legal Business Name): TAWFIK MUSSAD MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/11/2008
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

950 W WOOSTER ST
BOWLING GREEN OH
43402-2699
US

IV. Provider business mailing address

950 W WOOSTER ST
BOWLING GREEN OH
43402-2699
US

V. Phone/Fax

Practice location:
  • Phone: 419-354-8900
  • Fax: 419-354-3222
Mailing address:
  • Phone: 419-372-2271
  • Fax: 419-354-3222

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number35.156622
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number5501010890
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: