MEDICARE: AHMAD MOUSSAWI 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	208M00000X	Hospitalist Physician	35.142932	OH
2	207Q00000X	Family Medicine Physician	4301512624	MI
3	207Q00000X	Family Medicine Physician	35.142932	OH

General Provider Information

NPI Number	:	1568951689
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AHMAD MOUSSAWI MD

Provider Business Mailing Address
First Line	:	272 BENEDICT AVE
Second Line	:
City	:	NORWALK
State	:	OH
Zip	:	44857-2374
Country	:	US
Telephone Number	:	419-668-8101
Fax Number	:	419-660-6968

Provider Business Practice Location Address
First Line	:	272 BENEDICT AVE
Second Line	:
City	:	NORWALK
State	:	OH
Zip	:	44857-2374
Country	:	US
Telephone Number	:	419-668-8101
Fax Number	:	419-660-6968

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

Provider Enumeration Date	:	05/03/2018
Last Update Date	:	06/01/2026

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