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NPI Code Detail

MEDICARE: GHIATH A YAZJI MD

MEDICARE: GHIATH A YAZJI MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RC0000XCardiovascular Disease Physician35071709YOH

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2P00161449OTHEROHOHIO RAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1063419075
Entity Type Code : Individual
Provider Name (Legal Business Name) : GHIATH A YAZJI MD
Provider Business Mailing Address
First Line : 4235 SECOR RD
Second Line :
City : TOLEDO
State : OH
Zip : 43623-4231
Country : US
Telephone Number : 419-479-5690
Fax Number :
Provider Business Practice Location Address
First Line : 4235 SECOR RD
Second Line :
City : TOLEDO
State : OH
Zip : 43623-4231
Country : US
Telephone Number : 419-479-5690
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/05/2005
Last Update Date : 02/04/2010

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Directions to “ GHIATH A YAZJI MD” Practice Location

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