Provider Demographics
NPI:1033474598
Name:WAHBY, AZIZA A (DO)
Entity Type:Individual
Prefix:
First Name:AZIZA
Middle Name:A
Last Name:WAHBY
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2971 PAXTON RD
Mailing Address - Street 2:
Mailing Address - City:SHAKER HTS
Mailing Address - State:OH
Mailing Address - Zip Code:44120-1823
Mailing Address - Country:US
Mailing Address - Phone:216-932-5200
Mailing Address - Fax:216-932-5212
Practice Address - Street 1:4350 CROCKER RD STE 300
Practice Address - Street 2:
Practice Address - City:WESTLAKE
Practice Address - State:OH
Practice Address - Zip Code:44145
Practice Address - Country:US
Practice Address - Phone:440-646-1600
Practice Address - Fax:440-646-1505
Is Sole Proprietor?:No
Enumeration Date:2012-07-11
Last Update Date:2018-10-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH34011998207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0127078Medicaid
OHH558291OtherMEDICARE