Healthcare Provider Details

I. General information

NPI: 1386886851
Provider Name (Legal Business Name): BILAL MOUSA ATAYA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/31/2009
Last Update Date: 07/28/2025
Certification Date: 07/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30680 BAINBRIDGE RD
CLEVELAND OH
44139-2282
US

IV. Provider business mailing address

3016 RIVIERA LN APT SUITE
WESTLAKE OH
44145-6843
US

V. Phone/Fax

Practice location:
  • Phone: 440-542-5000
  • Fax:
Mailing address:
  • Phone: 216-659-3035
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number35.099050
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number35.099050
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number94293
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: