Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RR0500X | Rheumatology | 35059458D | OH |
NPI | 1063488765 |
---|---|
Provider Name | Isam Diab |
First Address | Rocky River, OH 44116 |
Second Address | Middleburg Hts, OH 44130 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/02/2006 |
Last Update Date | 27/05/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000031889 | ANTHEM (01) | |
0119204 | GROUP MEDICAID (01) | |
0786707 | (05) | OH |
102940 | KAISER (01) | |
1780634279 | GROUP NPI (01) | |
3200064 | UNITED HEALTHCARE (01) | |
341783789049 | CARESOURCE (01) | |
350849 | WELLCARE MEDICAID (01) | |
3610861 | ASC GROUP MEDICARE (01) | OH |
4247166 | AETNA (01) | OH |
9273172 | GROUP MEDICARE (01) | OH |
CA4511 | RR MEDICARE GROUP (01) | |
D368301 | DIAGNOSTIC GROUP MEDICARE (01) | OH |
E54689 | (02) | |
F59458 | SUMMACARE APEX (01) |