Healthcare Provider Details

I. General information

NPI: 1235670951
Provider Name (Legal Business Name): GHIATH ALNOURI M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/14/2017
Last Update Date: 03/25/2025
Certification Date: 03/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

770 W HIGH ST STE 460
LIMA OH
45801-5908
US

IV. Provider business mailing address

PO BOX 7527
DUBLIN OH
43017-0727
US

V. Phone/Fax

Practice location:
  • Phone: 419-226-4300
  • Fax: 419-226-4305
Mailing address:
  • Phone: 419-520-2495
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number35.143214
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: