Healthcare Provider Details

I. General information

NPI: 1679542567
Provider Name (Legal Business Name): NIZAR ZAHI NADER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/14/2006
Last Update Date: 07/31/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12000 MCCRACKEN RD #201
GARFIELD HTS OH
44125-2964
US

IV. Provider business mailing address

1450 SOM CENTER RD #25
MAYFIELD HTS OH
44124-2118
US

V. Phone/Fax

Practice location:
  • Phone: 216-663-1274
  • Fax: 216-663-1474
Mailing address:
  • Phone: 440-446-1423
  • Fax: 440-446-1498

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number35-082942
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number35-082942
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: