Healthcare Provider Details

I. General information

NPI: 1275014151
Provider Name (Legal Business Name): NABEEL ISMAIL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/28/2018
Last Update Date: 08/28/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3333 BURNET AVE # 5037
CINCINNATI OH
45229-3026
US

IV. Provider business mailing address

3333 BURNET AVE # 5037
CINCINNATI OH
45229-3026
US

V. Phone/Fax

Practice location:
  • Phone: 513-636-4975
  • Fax: 513-636-6753
Mailing address:
  • Phone: 513-636-4975
  • Fax: 513-636-6753

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number57.246757
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: