Healthcare Provider Details

I. General information

NPI: 1700615978
Provider Name (Legal Business Name): MO'TASEM ZUHIER (M. R.) DWEEKAT MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/29/2024
Last Update Date: 07/29/2024
Certification Date: 07/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11100 EUCLID AVE
CLEVELAND OH
44106-1716
US

IV. Provider business mailing address

12550 LAKE AVE APT 1410
LAKEWOOD OH
44107-1570
US

V. Phone/Fax

Practice location:
  • Phone: 216-983-9163
  • Fax:
Mailing address:
  • Phone: 216-200-1510
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number57.255827
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: