Provider Demographics
NPI:1588602627
Name:AL-MARRAWI, MHD YASER (MD)
Entity Type:Individual
Prefix:
First Name:MHD
Middle Name:YASER
Last Name:AL-MARRAWI
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 1:1125 ASPIRA CT
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44906-4125
Mailing Address - Country:US
Mailing Address - Phone:419-756-2122
Mailing Address - Fax:419-756-3530
Practice Address - Street 1:1125 ASPIRA CT
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:OH
Practice Address - Zip Code:44906
Practice Address - Country:US
Practice Address - Phone:419-756-2122
Practice Address - Fax:419-756-3530
Is Sole Proprietor?:No
Enumeration Date:2006-06-02
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.082422207R00000X
PAMD421459207RH0003X
OH35082422207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2424326Medicaid
OHBA8261226OtherDEA
H83086Medicare UPIN
OH2424326Medicaid
OHAL4105814Medicare PIN