Healthcare Provider Details

I. General information

NPI: 1578739405
Provider Name (Legal Business Name): WAFA AKKAD M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/30/2008
Last Update Date: 02/26/2020
Certification Date: 02/26/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3145 HAMILTON MASON RD STE 200A
FAIRFIELD TOWNSHIP OH
45011-8556
US

IV. Provider business mailing address

3145 HAMILTON MASON RD STE 200A
FAIRFIELD TOWNSHIP OH
45011-8556
US

V. Phone/Fax

Practice location:
  • Phone: 513-863-6222
  • Fax: 513-863-6478
Mailing address:
  • Phone: 513-863-6222
  • Fax: 513-863-6478

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number35.133092
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: