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NPI Code Detail

MEDICARE: HAISSAM MAHMOUD GAMALELDIN M.D.

MEDICARE: HAISSAM MAHMOUD GAMALELDIN M.D.
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
1207L00000XAnesthesiology Physician35080274OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1831190289
Entity Type Code : Individual
Provider Name (Legal Business Name) : HAISSAM MAHMOUD GAMALELDIN M.D.
Provider Business Mailing Address
First Line : PO BOX 30
Second Line :
City : RAVENNA
State : OH
Zip : 44266-0030
Country : US
Telephone Number : 216-476-7052
Fax Number :
Provider Business Practice Location Address
First Line : 18101 LORAIN AVE
Second Line :
City : CLEVELAND
State : OH
Zip : 44111-5612
Country : US
Telephone Number : 216-476-7052
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/09/2005
Last Update Date : 11/19/2009

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