Healthcare Provider Details

I. General information

NPI: 1063615375
Provider Name (Legal Business Name): SHAZA DAOUD MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/06/2007
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5500 BROADVIEW RD
PARMA OH
44134-1606
US

IV. Provider business mailing address

5500 BROADVIEW RD
PARMA OH
44134-1606
US

V. Phone/Fax

Practice location:
  • Phone: 216-351-7700
  • Fax: 216-785-9400
Mailing address:
  • Phone: 440-979-1432
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number35.094454
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number35.094454
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: