Basic Information
| Provider Information | |||||||||
| NPI: | 1780849539 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | TABBOSHA | ||||||||
| FirstName: | MONIR | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9250 BLUE ASH RD | ||||||||
| Address2: | |||||||||
| City: | BLUE ASH | ||||||||
| State: | OH | ||||||||
| PostalCode: | 452426822 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5137927443 | ||||||||
| FaxNumber: | 5137914042 | ||||||||
| Practice Location | |||||||||
| Address1: | 9250 BLUE ASH RD | ||||||||
| Address2: | |||||||||
| City: | BLUE ASH | ||||||||
| State: | OH | ||||||||
| PostalCode: | 452426822 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5137927443 | ||||||||
| FaxNumber: | 5137914042 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/22/2008 | ||||||||
| LastUpdateDate: | 10/22/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/22/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207T00000X | 35.130725 | OH | Y | Allopathic & Osteopathic Physicians | Neurological Surgery | 207T00000X | E8249 | AR | N | Allopathic & Osteopathic Physicians | Neurological Surgery |
No ID Information.