Healthcare Provider Details

I. General information

NPI: 1962258749
Provider Name (Legal Business Name): DR. MUHAMMAD OWAIS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/24/2024
Last Update Date: 04/24/2024
Certification Date: 04/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5969 E BROAD ST STE 303
COLUMBUS OH
43213-1539
US

IV. Provider business mailing address

4071 LEE RD STE 260
CLEVELAND OH
44128-2173
US

V. Phone/Fax

Practice location:
  • Phone: 216-727-0124
  • Fax:
Mailing address:
  • Phone: 216-727-0124
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberRES.004732
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: