Provider Demographics
NPI:1255302808
Name:ABOU-ELSAAD, TAMER Y (MD)
Entity Type:Individual
Prefix:
First Name:TAMER
Middle Name:Y
Last Name:ABOU-ELSAAD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7495 STATE RD STE 200
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45255-6400
Mailing Address - Country:US
Mailing Address - Phone:513-732-8377
Mailing Address - Fax:513-732-2618
Practice Address - Street 1:7495 STATE RD
Practice Address - Street 2:200
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45255-2498
Practice Address - Country:US
Practice Address - Phone:513-732-8377
Practice Address - Fax:513-732-2618
Is Sole Proprietor?:No
Enumeration Date:2006-01-31
Last Update Date:2020-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH350891272084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2731486Medicaid
P00780634OtherMEDICARE RR
P00780634OtherMEDICARE RR
OH2731486Medicaid