Healthcare Provider Details

I. General information

NPI: 1164771739
Provider Name (Legal Business Name): BASHAR ALOLABI MD, FRCSC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/29/2012
Last Update Date: 05/02/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9500 EUCLID AVE A-41
CLEVELAND OH
44195-0001
US

IV. Provider business mailing address

9500 EUCLID AVE A-41. DR. J. IANNOTTI'S OFFICE
CLEVELAND OH
44195-0001
US

V. Phone/Fax

Practice location:
  • Phone: 216-445-5151
  • Fax:
Mailing address:
  • Phone: 216-445-5151
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XS0114X
TaxonomyAdult Reconstructive Orthopaedic Surgery Physician
License Number35.099610
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: