Provider Demographics
NPI:1659725877
Name:ISMAIL, HIBAH H
Entity Type:Individual
Prefix:
First Name:HIBAH
Middle Name:H
Last Name:ISMAIL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:LABBAN STREET
Mailing Address - Street 2:MAHMASSANI BUILDING
Mailing Address - City:BEIRUT
Mailing Address - State:BEIRUT
Mailing Address - Zip Code:00000
Mailing Address - Country:LB
Mailing Address - Phone:009617-082-9378
Mailing Address - Fax:
Practice Address - Street 1:2142 N COVE BLVD
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43606-3895
Practice Address - Country:US
Practice Address - Phone:419-291-4188
Practice Address - Fax:419-291-4133
Is Sole Proprietor?:No
Enumeration Date:2016-04-14
Last Update Date:2019-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
OH35135572208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program