Healthcare Provider Details

I. General information

NPI: 1548197684
Provider Name (Legal Business Name): MAZEN A MAHJOUB MD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/05/2026
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9375 E MARKET ST STE 3
WARREN OH
44484-5552
US

IV. Provider business mailing address

9375 E MARKET ST STE 3
WARREN OH
44484-5552
US

V. Phone/Fax

Practice location:
  • Phone: 330-392-0100
  • Fax: 330-392-0047
Mailing address:
  • Phone: 330-392-0100
  • Fax: 330-392-0047

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: MAZEN A MAHJOUB
Title or Position: OWNER
Credential: MD
Phone: 330-717-6003