Provider Demographics
NPI:1730296237
Name:DABIS, NAZIH JAMIL (MD)
Entity Type:Individual
Prefix:
First Name:NAZIH
Middle Name:JAMIL
Last Name:DABIS
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 1:950 S MAIN ST STE 6
Mailing Address - Street 2:
Mailing Address - City:CELINA
Mailing Address - State:OH
Mailing Address - Zip Code:45822-2467
Mailing Address - Country:US
Mailing Address - Phone:419-586-1655
Mailing Address - Fax:419-586-6338
Practice Address - Street 1:950 S MAIN ST STE 6
Practice Address - Street 2:
Practice Address - City:CELINA
Practice Address - State:OH
Practice Address - Zip Code:45822
Practice Address - Country:US
Practice Address - Phone:419-586-1655
Practice Address - Fax:419-586-6338
Is Sole Proprietor?:No
Enumeration Date:2006-08-23
Last Update Date:2018-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH45580208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0437996Medicaid
OH0437996Medicaid