Provider Demographics
NPI:1760140602
Name:KADHIM, TAREQ ABED
Entity Type:Individual
Prefix:
First Name:TAREQ
Middle Name:ABED
Last Name:KADHIM
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 1:5696 KILBURY LN
Mailing Address - Street 2:
Mailing Address - City:HILLIARD
Mailing Address - State:OH
Mailing Address - Zip Code:43026-8398
Mailing Address - Country:US
Mailing Address - Phone:614-822-0763
Mailing Address - Fax:614-522-3006
Practice Address - Street 1:5696 KILBURY LN
Practice Address - Street 2:
Practice Address - City:HILLIARD
Practice Address - State:OH
Practice Address - Zip Code:43026-8398
Practice Address - Country:US
Practice Address - Phone:614-822-0763
Practice Address - Fax:614-522-3006
Is Sole Proprietor?:No
Enumeration Date:2021-12-07
Last Update Date:2021-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHGO9210171WH0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171WH0202XOther Service ProvidersContractorHome Modifications