Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0210X | Pediatric Nephrologist | 35070302 | OH |
N | 2080P0210X | Pediatric Nephrologist | 4301064550 | MI |
NPI | 1346233319 |
---|---|
Provider Name | Ridwan M. Tarabishi |
First Address | Toledo, OH 43608-2675 |
Second Address | Toledo, OH 43608-2675 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/08/2005 |
Last Update Date | 19/03/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0459570 | (05) | OH |
G49527 | (02) | OH |