Healthcare Provider Details

I. General information

NPI: 1780589846
Provider Name (Legal Business Name): OMAR AHMED HAMED ALWAHOUSH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/09/2026
Last Update Date: 10/09/2026
Certification Date: 10/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9500 EUCLID AVE
CLEVELAND OH
44195
US

IV. Provider business mailing address

1878 E 90TH ST APT 218
CLEVELAND OH
44106-8001
US

V. Phone/Fax

Practice location:
  • Phone: 216-296-9117
  • Fax:
Mailing address:
  • Phone: 216-296-9117
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number57.261345
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: