| Doctor Name: | DR. MOHAMED BASHAR MAMLOUK |
| NPI Number: | 1306805304 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | 35-038540 |
| Business Practice Address: | 20455 Lorain Rd Ste 104b Fairview Park, OH - 441263529 |
| Business Phone Number: | 4403562715 |
| Business Fax Number: | 4403566978 |
| Mailing Address: | 30701 Lorain Rd Ste A, NORTH OLMSTED |
| State: | OH |
| Postal Code: | 440706325 |
| Phone Number: | 4402745035 |
| Fax Number: | 4407168608 |
| NPI Enumeration Date: | 03/20/2006 |
| NPI Last Update Date: | 02/13/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 207RC0000X |
| License Number: | 35-038540 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OH |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Internal Medicine |
| Taxonomy Specialization: | Cardiovascular Disease |
| Taxonomy Definition: | An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |