Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0207X | Pediatric Hematology-Oncologist | 35-066805 | OH |
N | 2080P0207X | Pediatric Hematology-Oncologist | 42473 | WI |
NPI | 1194791855 |
---|---|
Provider Name | Yousif H Matloub |
First Address | Euclid, OH 44117-1714 |
Second Address | Cleveland, OH 44106-1716 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/02/2006 |
Last Update Date | 24/01/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0982790 | (05) | OH |
34012500 | (05) | WI |
F83837 | (02) |