Basic Information
| Provider Information | |||||||||
| NPI: | 1033414081 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | AMJAD RASS INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 61353 SOUTHGATE RD | ||||||||
| Address2: | |||||||||
| City: | CAMBRIDGE | ||||||||
| State: | OH | ||||||||
| PostalCode: | 437256607 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 61353 SOUTHGATE RD | ||||||||
| Address2: | |||||||||
| City: | CAMBRIDGE | ||||||||
| State: | OH | ||||||||
| PostalCode: | 437256607 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7404358585 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 01/24/2011 | ||||||||
| LastUpdateDate: | 01/24/2011 | ||||||||
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| AuthorizedOfficialLastName: | RASS | ||||||||
| AuthorizedOfficialFirstName: | AMJAD | ||||||||
| AuthorizedOfficialMiddleName: | A | ||||||||
| AuthorizedOfficialTitleorPosition: | CEO | ||||||||
| AuthorizedOfficialTelephone: | 7404358585 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QR1300X | Y | Ambulatory Health Care Facilities | Clinic/Center | Rural Health |
No ID Information.