Dallal, Mohammed Mazen

Dallal, Mohammed Mazen is an individual health care provider with primary practice located at 1520 S Main St # 2, Dayton OH 45409-2698. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Critical Care Medicine, Allopathic & Osteopathic Physicians / Sleep Medicine, Allopathic & Osteopathic Physicians / Pulmonary Disease. Allopathic & Osteopathic Physicians / Pulmonary Disease is his primary health care specialty. Dallal, Mohammed Mazen can be contacted via phone (937) 461-5815.

Contact Information

Primary practice address
1520 S Main St # 2 Dayton OH 45409-2698
Phone: (937) 461-5815
Fax: (937) 461-2896
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Critical Care Medicine 207RC0200X 35067761 Ohio
Allopathic & Osteopathic Physicians / Sleep Medicine 207RS0012X 35067761 Ohio
Allopathic & Osteopathic Physicians / Pulmonary Disease 207RP1001X 35067761 Ohio

Profile Details

NPI number 1366434995
LBN Legal business name Dallal, Mohammed Mazen
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 19th, 2005
Last updated Dec 14th, 2022 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1366434995 NPPES
Ohio Other 000000012616 ANTHEM BCBS
Ohio MEDICAID 0178196 ANTHEM BCBS
Ohio Other 4820106 ANTHEM BCBS

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