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NPI Code Detail

MEDICARE: AMJAD TARBOOSH

MEDICARE: AMJAD TARBOOSH
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
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1750843009
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMJAD TARBOOSH
Provider Business Mailing Address
First Line : 2222 CHERRY ST STE M200
Second Line :
City : TOLEDO
State : OH
Zip : 43608-2674
Country : US
Telephone Number : 419-251-8019
Fax Number : 419-251-5819
Provider Business Practice Location Address
First Line : 2222 CHERRY ST STE M200
Second Line :
City : TOLEDO
State : OH
Zip : 43608-2674
Country : US
Telephone Number : 419-251-8019
Fax Number : 419-251-5819
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/04/2019
Last Update Date : 06/29/2020

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Directions to “ AMJAD TARBOOSH ” Practice Location

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