MEDICARE: SAMI I M GHAZALEH 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	390200000X	Student in an Organized Health Care Education/Training Program
2	390200000X	Student in an Organized Health Care Education/Training Program	35.151245	OH
3	207RG0100X	Gastroenterology Physician	35.151245	OH

Other Identifiers

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

General Provider Information

NPI Number	:	1164918355
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SAMI I M GHAZALEH MD

Provider Business Mailing Address
First Line	:	3000 ARLINGTON AVE STOP 1108
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43614-2598
Country	:	US
Telephone Number	:	419-383-5322
Fax Number	:

Provider Business Practice Location Address
First Line	:	1125 HOSPITAL DR STE 1620
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43614-8001
Country	:	US
Telephone Number	:	419-383-6105
Fax Number	:

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

Provider Enumeration Date	:	07/10/2018
Last Update Date	:	01/12/2026

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Directions to “ SAMI I M GHAZALEH MD” Practice Location

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