Healthcare Provider Details

I. General information

NPI: 1821226655
Provider Name (Legal Business Name): NOUHAD RAISSOUNI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/01/2009
Last Update Date: 04/05/2022
Certification Date: 04/05/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9500 EUCLID AVE # A120
CLEVELAND OH
44195-0001
US

IV. Provider business mailing address

9500 EUCLID AVE # A120
CLEVELAND OH
44195-0001
US

V. Phone/Fax

Practice location:
  • Phone: 216-444-7556
  • Fax:
Mailing address:
  • Phone: 347-977-8810
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2080P0205X
TaxonomyPediatric Endocrinology Physician
License Number2022-00386
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number35.099110
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: