Healthcare Provider Details

I. General information

NPI: 1003813205
Provider Name (Legal Business Name): GHASSAN S SAFADI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/01/2005
Last Update Date: 06/30/2025
Certification Date: 06/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7615 KINGS POINTE RD
TOLEDO OH
43617-1514
US

IV. Provider business mailing address

PO BOX 352108
TOLEDO OH
43635-2108
US

V. Phone/Fax

Practice location:
  • Phone: 419-843-7780
  • Fax: 419-517-0216
Mailing address:
  • Phone: 419-843-7780
  • Fax: 419-517-0216

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number35062753
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: