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1790807675

NPI Code Detail

MEDICARE: HASSAN ALI DBOUK MD

MEDICARE: HASSAN ALI DBOUK 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	2080P0214X	Pediatric Pulmonology Physician	ME120102	FL
2	2080P0203X	Pediatric Critical Care Medicine Physician	28846	WV
3	2080P0214X	Pediatric Pulmonology Physician	26020	OK
4	208M00000X	Hospitalist Physician	35-076143	OH
5	2080S0012X	Pediatric Sleep Medicine Physician	35.076143	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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1790807675
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HASSAN ALI DBOUK MD

Provider Business Mailing Address
First Line	:	PO BOX 933432
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44193-0039
Country	:	US
Telephone Number	:	937-641-5072
Fax Number	:	937-641-6129

Provider Business Practice Location Address
First Line	:	1 CHILDRENS PLZ
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45404-1815
Country	:	US
Telephone Number	:	937-641-4000
Fax Number	:	937-641-6492

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

Provider Enumeration Date	:	04/04/2007
Last Update Date	:	11/11/2025

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Directions to “ HASSAN ALI DBOUK 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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