Healthcare Provider Details

I. General information

NPI: 1730507427
Provider Name (Legal Business Name): ISSA REZEK M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2014
Last Update Date: 08/12/2024
Certification Date: 08/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 METROHEALTH DR STE 325
CLEVELAND OH
44109-1900
US

IV. Provider business mailing address

2500 METROHEALTH DR STE 325
CLEVELAND OH
44109-1900
US

V. Phone/Fax

Practice location:
  • Phone: 216-778-5461
  • Fax: 216-778-3062
Mailing address:
  • Phone: 216-778-5461
  • Fax: 216-778-3062

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License Number35.149616
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: