Basic Information
| Provider Information | |||||||||
| NPI: | 1801091541 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | JAFRI | ||||||||
| FirstName: | HASEEB | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1380 E STROOP RD | ||||||||
| Address2: | |||||||||
| City: | KETTERING | ||||||||
| State: | OH | ||||||||
| PostalCode: | 454294926 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9372933486 | ||||||||
| FaxNumber: | 9372933605 | ||||||||
| Practice Location | |||||||||
| Address1: | 8057 WASHINGTON VILLAGE DR | ||||||||
| Address2: | |||||||||
| City: | CENTERVILLE | ||||||||
| State: | OH | ||||||||
| PostalCode: | 454581847 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9373129890 | ||||||||
| FaxNumber: | 9373129810 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/20/2007 | ||||||||
| LastUpdateDate: | 01/20/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 01/20/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RC0001X | 35128513 | OH | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Clinical Cardiac Electrophysiology | 207R00000X | 35128513 | OH | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | 232787 | MA | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207RC0000X | 35128513 | OH | N | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease |
ID Information
| ID | Type | State | Issuer | Description | 0168177 | 05 | OH | MEDICAID |