Provider Demographics
NPI:1598869174
Name:GHAZI, MOHIUDDIN (MD)
Entity Type:Individual
Prefix:DR
First Name:MOHIUDDIN
Middle Name:
Last Name:GHAZI
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 1:5450 FRANTZ RD STE 360
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43016-4141
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:900 MEADOW DR
Practice Address - Street 2:SUITE B
Practice Address - City:MOUNT GILEAD
Practice Address - State:OH
Practice Address - Zip Code:43338-1063
Practice Address - Country:US
Practice Address - Phone:678-766-3605
Practice Address - Fax:614-533-1442
Is Sole Proprietor?:No
Enumeration Date:2006-09-12
Last Update Date:2022-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35065931207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH31142883000OtherBUREAU WORKERS COMP
OH0132976Medicaid
OH31142883000OtherBUREAU WORKERS COMP