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1508207689

NPI Code Detail

MEDICARE: FADY MARMOUSH MD

MEDICARE: FADY MARMOUSH 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	207R00000X	Internal Medicine Physician	LP02886	RI
2	207RI0011X	Interventional Cardiology Physician	59719	AZ
3	207RI0011X	Interventional Cardiology Physician	35.155150	OH
4	207RC0000X	Cardiovascular Disease Physician	59719	AZ

General Provider Information

NPI Number	:	1508207689
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FADY MARMOUSH MD

Provider Business Mailing Address
First Line	:	8055 MAYFIELD RD STE 105
Second Line	:
City	:	CHESTERLAND
State	:	OH
Zip	:	44026-2447
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	11100 EUCLID AVE
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44106-1716
Country	:	US
Telephone Number	:	216-844-7330
Fax Number	:

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

Provider Enumeration Date	:	07/17/2013
Last Update Date	:	05/14/2026

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Directions to “ FADY MARMOUSH MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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