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General NPI Number Information
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NPI Number | 1063488765
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Entity Type | Individual
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Provider Name | ISAM DIAB MD
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Gender | Male
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Dates
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Enumeration Date | 02/23/2006
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Last Update Date | 05/27/2008
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Provider Practice Location Address
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Address Line | 18660 BAGLEY ROAD #102B
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City | MIDDLEBURG HTS
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State | OH
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Zip | 44130
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Country | US
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Telephone | 440-891-9395
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Fax | 440-891-1765
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Provider Business Mailing Address
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Address Line | 20525 CENTER RIDGE ROAD SUITE 220
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City | ROCKY RIVER
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State | OH
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Zip | 44116
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Country | US
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Telephone | 440-895-5056
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Fax | 440-333-2935
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RR0500X
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Taxonomy Name | Rheumatology Physician
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License Number | 35059458D
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License Number State | OH
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