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General NPI Number Information
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NPI Number | 1841260189
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Entity Type | Individual
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Provider Name | OTHMAN ALY SHEMISA MD
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Gender | Male
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Dates
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Enumeration Date | 01/26/2006
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Last Update Date | 04/17/2019
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Provider Practice Location Address
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Address Line | 26908 COOK RD
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City | OLMSTED FALLS
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State | OH
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Zip | 44138-3548
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Country | US
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Telephone | 440-414-9700
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Fax | 440-235-1045
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Provider Business Mailing Address
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Address Line | 26908 COOK RD
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City | OLMSTED TWP
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State | OH
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Zip | 44138-3548
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Country | US
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Telephone | 440-414-9700
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Fax | 440-235-1045
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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 | 35053948
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License Number State | OH
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