Healthcare Provider Details

I. General information

NPI: 1093779811
Provider Name (Legal Business Name): LEILA DONNA HOSSEINI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/17/2006
Last Update Date: 03/03/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 ROSS PARK BLVD
STEUBENVILLE OH
43952-2671
US

IV. Provider business mailing address

380 SUMMIT AVE ATTN: PAMELA DICKINSON
STEUBENVILLE OH
43952-2667
US

V. Phone/Fax

Practice location:
  • Phone: 740-283-7677
  • Fax: 740-283-7110
Mailing address:
  • Phone: 740-283-7335
  • Fax: 740-283-7807

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number35083709
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: