Healthcare Provider Details

I. General information

NPI: 1922254697
Provider Name (Legal Business Name): MOHSEN HALABY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/13/2008
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4900 N MCCORD RD STE A1B
SYLVANIA OH
43560-3131
US

IV. Provider business mailing address

4900 N MCCORD RD STE A1B
SYLVANIA OH
43560-3131
US

V. Phone/Fax

Practice location:
  • Phone: 567-600-4598
  • Fax: 419-554-7265
Mailing address:
  • Phone: 567-600-4598
  • Fax: 419-554-7265

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number4301517181
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA105208
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number35.154933
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: