Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | 35062753 | OH |
NPI | 1003813205 |
---|---|
Provider Name | Dr. Ghassan S Safadi |
First Address | Toledo, OH 43635-2108 |
Second Address | Sylvania, OH 43560-9729 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/07/2005 |
Last Update Date | 15/01/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
03576 | PARAMOUNT HEALTH CARE (01) | OH |
0880953 | (05) | OH |
F30449 | (02) | OH |
P00274723 | RAILROAD MEDICARE ID (01) | OH |