Provider Demographics
NPI:1609431758
Name:MUHAMMAD, ISMAIL B
Entity Type:Individual
Prefix:MR
First Name:ISMAIL
Middle Name:B
Last Name:MUHAMMAD
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 1:28387 CENTER RIDGE RD APT B4
Mailing Address - Street 2:
Mailing Address - City:WESTLAKE
Mailing Address - State:OH
Mailing Address - Zip Code:44145-3855
Mailing Address - Country:US
Mailing Address - Phone:216-502-6775
Mailing Address - Fax:
Practice Address - Street 1:28387 CENTER RIDGE RD APT B4
Practice Address - Street 2:
Practice Address - City:WESTLAKE
Practice Address - State:OH
Practice Address - Zip Code:44145-3855
Practice Address - Country:US
Practice Address - Phone:216-502-6775
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-03
Last Update Date:2019-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3747A0650X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider