Basic Information
| Provider Information | |||||||||
| NPI: | 1376778696 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HALLAJ | ||||||||
| FirstName: | MAZIN | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7730 FIRST PL | ||||||||
| Address2: | SUITE D | ||||||||
| City: | OAKWOOD VILLAGE | ||||||||
| State: | OH | ||||||||
| PostalCode: | 441466719 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4407350438 | ||||||||
| FaxNumber: | 4407350484 | ||||||||
| Practice Location | |||||||||
| Address1: | 7730 FIRST PL | ||||||||
| Address2: | SUITE D | ||||||||
| City: | OAKWOOD VILLAGE | ||||||||
| State: | OH | ||||||||
| PostalCode: | 441466719 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4407350438 | ||||||||
| FaxNumber: | 4407350484 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/17/2009 | ||||||||
| LastUpdateDate: | 04/27/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | 0101245226 | VA | N | Allopathic & Osteopathic Physicians | Emergency Medicine | 2083X0100X | 0101245226 | VA | N | Allopathic & Osteopathic Physicians | Preventive Medicine | Occupational Medicine | 2083X0100X | 124411 | OH | Y | Allopathic & Osteopathic Physicians | Preventive Medicine | Occupational Medicine |
No ID Information.