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General NPI Number Information
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NPI Number | 1912987959
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Entity Type | Individual
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Provider Name | FADI NADDOUR
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Gender | Male
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Dates
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Enumeration Date | 01/17/2006
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Last Update Date | 10/29/2008
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Provider Practice Location Address
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Address Line | 1353 E MARKET ST
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City | WARREN
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State | OH
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Zip | 44483-6626
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Country | US
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Telephone | 330-399-3222
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 4229
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City | WARREN
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State | OH
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Zip | 44482-4229
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Country | US
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Telephone | 330-399-3222
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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 | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 35079246
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License Number State | OH
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