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General NPI Number Information
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NPI Number | 1134627896
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Entity Type | Organization
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Legal Business Name | BSHARA & ASSOCIATES INC
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Dates
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Enumeration Date | 01/29/2018
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Last Update Date | 06/28/2019
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Provider Practice Location Address
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Address Line | 3665 W 117TH ST
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City | CLEVELAND
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State | OH
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Zip | 44111-5215
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Country | US
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Telephone | 216-351-0778
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Fax | 216-251-5963
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Provider Business Mailing Address
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Address Line | 7550 LUCERNE DR. STE 405
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City | MIDDLEBURG HTS
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State | OH
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Zip | 44130-6503
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Country | US
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Telephone | 440-234-8833
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Fax | 440-234-3313
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Authorized Official
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Title or Position | OWNER
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Name | IBRAHIM BSHARA
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Credential | MD
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Telephone | 216-351-0778
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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