Provider Demographics
NPI:1093914327
Name:ABUNASSER, JAFAR JAMIL
Entity Type:Individual
Prefix:
First Name:JAFAR
Middle Name:JAMIL
Last Name:ABUNASSER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9500 EUCLID AVE
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44195-0001
Mailing Address - Country:US
Mailing Address - Phone:216-587-8830
Mailing Address - Fax:216-587-8944
Practice Address - Street 1:9500 EUCLID AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44195-1800
Practice Address - Country:US
Practice Address - Phone:216-587-8830
Practice Address - Fax:216-587-8944
Is Sole Proprietor?:No
Enumeration Date:2007-07-17
Last Update Date:2019-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP7235207RC0200X, 207RP1001X
OH35094872207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX3305542-01Medicaid
OH3051576Medicaid
TX3305542-01Medicaid
OH3051576Medicaid