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General NPI Number Information
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NPI Number | 1922292093
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Entity Type | Individual
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Provider Name | BASMA AL MANDIL MD
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Gender | Female
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Dates
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Enumeration Date | 08/31/2007
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Last Update Date | 12/16/2024
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Provider Practice Location Address
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Address Line | 29099 HEALTH CAMPUS DR STE 130
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City | WESTLAKE
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State | OH
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Zip | 44145-5255
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Country | US
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Telephone | 440-835-6163
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Fax | 440-871-9408
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Provider Business Mailing Address
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Address Line | 15805 PURITAS AVE
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City | CLEVELAND
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State | OH
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Zip | 44135-2611
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Country | US
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Telephone | 216-267-5139
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Fax | 216-267-5133
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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 | 207RC0200X
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Taxonomy Name | Critical Care Medicine (Internal Medicine) Physician
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License Number | 35089919
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 207RS0012X
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Taxonomy Name | Sleep Medicine (Internal Medicine) Physician
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License Number | 35089919
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | 35.089919
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License Number State | OH
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