MEDICARE: MASSOOD R BABAI 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	2084P0805X	Geriatric Psychiatry Physician	35034523B	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	:	1215947395
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MASSOOD R BABAI MD

Provider Business Mailing Address
First Line	:	275 GRAHAM RD
Second Line	:	#8
City	:	CUYAHOGA FALLS
State	:	OH
Zip	:	44223-2259
Country	:	US
Telephone Number	:	330-929-8631
Fax Number	:	330-929-1686

Provider Business Practice Location Address
First Line	:	275 GRAHAM RD
Second Line	:	#8
City	:	CUYAHOGA FALLS
State	:	OH
Zip	:	44223-2259
Country	:	US
Telephone Number	:	330-929-8631
Fax Number	:	330-929-1686

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

Provider Enumeration Date	:	08/09/2006
Last Update Date	:	11/13/2012

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