Provider Demographics
NPI:1376578633
Name:LABIB-TAKLA, AMGAD NABIL (MD)
Entity type:Individual
Prefix:DR
First Name:AMGAD
Middle Name:NABIL
Last Name:LABIB-TAKLA
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 1:1493 S HAWKINS AVE
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44320-3416
Mailing Address - Country:US
Mailing Address - Phone:330-865-5333
Mailing Address - Fax:
Practice Address - Street 1:1493 S HAWKINS AVE
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44320-3416
Practice Address - Country:US
Practice Address - Phone:330-865-5333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2024-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME016645207L00000X
OH35.082573208VP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
I22077Medicare UPIN
MF1041Medicare ID - Type Unspecified