Provider Demographics
NPI:1790122893
Name:ASADI, TANNAZ (MD)
Entity Type:Individual
Prefix:
First Name:TANNAZ
Middle Name:
Last Name:ASADI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3609 PARK EAST DR STE 207
Mailing Address - Street 2:
Mailing Address - City:BEACHWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44122-4309
Mailing Address - Country:US
Mailing Address - Phone:216-360-0456
Mailing Address - Fax:216-360-9449
Practice Address - Street 1:3609 PARK EAST DR STE 207
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44122
Practice Address - Country:US
Practice Address - Phone:216-360-0456
Practice Address - Fax:216-360-9449
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-29
Last Update Date:2018-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH57.022435207R00000X
OH35.128083207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine