Healthcare Provider Details

I. General information

NPI: 1518147750
Provider Name (Legal Business Name): RIFFAT QADIR, M.D., INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/05/2007
Last Update Date: 11/05/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3838 MASSILLON RD STE 380A
UNIONTOWN OH
44685-6214
US

IV. Provider business mailing address

3838 MASSILLON ROAD SUITE 380A
UNIONTOWN OH
44685
US

V. Phone/Fax

Practice location:
  • Phone: 330-899-0050
  • Fax: 330-899-0060
Mailing address:
  • Phone: 330-899-0050
  • Fax: 330-899-0060

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberA01342
License Number StateOH

VIII. Authorized Official

Name: DR. RIFFAT QADIR
Title or Position: OTOLARYNGOLOGIST
Credential: M.D.
Phone: 330-899-0050