Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | 34011998 | OH |
NPI | 1033474598 |
---|---|
Provider Name | Aziza A Wahby |
First Address | Shaker Hts, OH 44120-1823 |
Second Address | Westlake, OH 44145 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/07/2012 |
Last Update Date | 08/10/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0127078 | (05) | OH |
H558291 | MEDICARE (01) | OH |