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General NPI Number Information
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NPI Number | 1235306507
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Entity Type | Individual
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Provider Name | OMAR FAISAL KHATIB M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/14/2008
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Last Update Date | 04/24/2025
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Provider Practice Location Address
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Address Line | 9500 EUCLID AVE A91
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City | CLEVELAND
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State | OH
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Zip | 44195-0001
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Country | US
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Telephone | 216-445-8975
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Fax |
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Provider Business Mailing Address
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Address Line | 29050 DETROIT RD APT 220
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City | WESTLAKE
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State | OH
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Zip | 44145-2092
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Country | US
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Telephone | 440-250-1572
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Fax |
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 35.094154
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 207RI0011X
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Taxonomy Name | Interventional Cardiology Physician
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License Number | 01073890A
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License Number State | IN
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