Provider Demographics
NPI:1275599763
Name:BAHHUR, NAEL O (MD)
Entity Type:Individual
Prefix:DR
First Name:NAEL
Middle Name:O
Last Name:BAHHUR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:3355 GLENDALE AVE FL 3
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43614-2426
Mailing Address - Country:US
Mailing Address - Phone:419-383-3888
Mailing Address - Fax:419-383-2860
Practice Address - Street 1:3000 ARLINGTON AVE
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43614
Practice Address - Country:US
Practice Address - Phone:419-383-3888
Practice Address - Fax:419-383-2860
Is Sole Proprietor?:No
Enumeration Date:2006-04-24
Last Update Date:2019-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35087496207Q00000X
MI4301090929207QS0010X
OH35.087496207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2645187Medicaid
MI5195110Medicaid
06806OtherPARAMOUNT
423431OtherPRIORITY HEALTH
MI5195110Medicaid
P00452757OtherRRMC
9987050OtherAETNA
000000537144OtherANTHEM
MI5195110Medicaid
$$$$$$$$$OtherTRICARE
OHBA6034321Medicare PIN
9987050OtherAETNA
OHI51277Medicare UPIN