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General NPI Number Information
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NPI Number | 1548902018
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Entity Type | Individual
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Provider Name | JOHNNY DEEB ABI-RACHED DO
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Gender | Male
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Dates
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Enumeration Date | 04/13/2022
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Last Update Date | 08/20/2025
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Provider Practice Location Address
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Address Line | 1607 STATE RD STE 6
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City | VERMILION
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State | OH
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Zip | 44089-9142
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Country | US
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Telephone | 440-967-8713
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Fax | 440-967-1938
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Provider Business Mailing Address
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Address Line | 1607 STATE RD STE 6
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City | VERMILION
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State | OH
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Zip | 44089-9142
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Country | US
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Telephone | 440-967-8713
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Fax | 440-967-1938
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 34.018048
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License Number State | OH
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