Provider Demographics
NPI:1184854317
Name:JARADAT, DIMA MOHAMMAD (MD)
Entity Type:Individual
Prefix:
First Name:DIMA
Middle Name:MOHAMMAD
Last Name:JARADAT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1002 EAGLE DR
Mailing Address - Street 2:APT 201
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44312-5842
Mailing Address - Country:US
Mailing Address - Phone:330-564-6950
Mailing Address - Fax:
Practice Address - Street 1:400 WABASH AVE
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44307-2433
Practice Address - Country:US
Practice Address - Phone:330-344-6015
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-22
Last Update Date:2009-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program