MEDICARE: DR. JABER ALANZI 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
1	208600000X	Surgery Physician	MT195306	PA
2	390200000X	Student in an Organized Health Care Education/Training Program	MT195306	PA
3	208800000X	Urology Physician	35.126000	OH

General Provider Information

NPI Number	:	1073748257
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JABER ALANZI MD

Provider Business Mailing Address
First Line	:	1001 BELLEFONTAINE AVE
Second Line	:
City	:	LIMA
State	:	OH
Zip	:	45804-2800
Country	:	US
Telephone Number	:	419-998-4575
Fax Number	:	419-998-4586

Provider Business Practice Location Address
First Line	:	6900 PEARL RD STE 200
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44130-3640
Country	:	US
Telephone Number	:	440-845-0900
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/18/2009
Last Update Date	:	04/18/2024

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