Basic Information
| Provider Information | |||||||||
| NPI: | 1134627896 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | BSHARA & ASSOCIATES INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7550 LUCERNE DR. STE 405 | ||||||||
| Address2: | |||||||||
| City: | MIDDLEBURG HTS | ||||||||
| State: | OH | ||||||||
| PostalCode: | 441306503 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4402348833 | ||||||||
| FaxNumber: | 4402343313 | ||||||||
| Practice Location | |||||||||
| Address1: | 3665 W 117TH ST | ||||||||
| Address2: | |||||||||
| City: | CLEVELAND | ||||||||
| State: | OH | ||||||||
| PostalCode: | 441115215 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2163510778 | ||||||||
| FaxNumber: | 2162515963 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/29/2018 | ||||||||
| LastUpdateDate: | 06/28/2019 | ||||||||
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| AuthorizedOfficialLastName: | BSHARA | ||||||||
| AuthorizedOfficialFirstName: | IBRAHIM | ||||||||
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| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 2163510778 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.