Healthcare Provider Details

I. General information

NPI: 1558356535
Provider Name (Legal Business Name): ABBAS BABAKI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/15/2005
Last Update Date: 11/11/2024
Certification Date: 11/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

29000 CENTER RIDGE RD
WESTLAKE OH
44145-5293
US

IV. Provider business mailing address

PO BOX 39155
CLEVELAND OH
44139-0155
US

V. Phone/Fax

Practice location:
  • Phone: 440-835-8000
  • Fax:
Mailing address:
  • Phone: 440-542-5023
  • Fax: 440-542-5029

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number35045941B
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number35.045941
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: