Provider Demographics
NPI:1427581842
Name:AL-JARANI, BAHA'ADIN (MD)
Entity Type:Individual
Prefix:
First Name:BAHA'ADIN
Middle Name:
Last Name:AL-JARANI
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 1:1360 SCRANTON RD
Mailing Address - Street 2:
Mailing Address - City:NORWALK
Mailing Address - State:OH
Mailing Address - Zip Code:44857-9294
Mailing Address - Country:US
Mailing Address - Phone:937-216-5319
Mailing Address - Fax:
Practice Address - Street 1:1360 SCRANTON RD
Practice Address - Street 2:
Practice Address - City:NORWALK
Practice Address - State:OH
Practice Address - Zip Code:44857-9294
Practice Address - Country:US
Practice Address - Phone:379-216-5319
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-04
Last Update Date:2022-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.145523207RC0200X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program