Provider Demographics
NPI:1134356017
Name:OMER, TARIG ABDELHAMEED SAYED (MD)
Entity type:Individual
Prefix:
First Name:TARIG
Middle Name:ABDELHAMEED SAYED
Last Name:OMER
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 1:9500 EUCLID AVE OFC Q5-174
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44195-6595
Mailing Address - Country:US
Mailing Address - Phone:954-592-3925
Mailing Address - Fax:216-445-2536
Practice Address - Street 1:9500 EUCLID AVE OFC Q5-174
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44195-6595
Practice Address - Country:US
Practice Address - Phone:954-592-3925
Practice Address - Fax:216-445-2536
Is Sole Proprietor?:No
Enumeration Date:2009-06-17
Last Update Date:2022-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.099090207R00000X, 207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0066912Medicaid
OH0066912Medicaid
OHH102651Medicare PIN