Provider Demographics
NPI:1376287573
Name:ISTANBOULI, FAYEZ
Entity Type:Individual
Prefix:DR
First Name:FAYEZ
Middle Name:
Last Name:ISTANBOULI
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 1:797 E MARKET ST APT 202
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44305-2452
Mailing Address - Country:US
Mailing Address - Phone:216-744-7057
Mailing Address - Fax:
Practice Address - Street 1:797 E MARKET ST
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44305-2450
Practice Address - Country:US
Practice Address - Phone:216-744-7057
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-24
Last Update Date:2022-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-06-1242-1207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine