Healthcare Provider Details

I. General information

NPI: 1336758697
Provider Name (Legal Business Name): RATIB TALAL MAHFOUZ MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/23/2020
Last Update Date: 09/07/2026
Certification Date: 09/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CLEVELAND CLINIC 9500 EUCLID AVENUE/JJ24
CLEVELAND OH
44195-2759
US

IV. Provider business mailing address

1827 E 97TH ST TOWNHOME A UNIT A
CLEVELAND OH
44106
US

V. Phone/Fax

Practice location:
  • Phone: 216-444-2200
  • Fax:
Mailing address:
  • Phone: 401-368-8341
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number35.153878
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: