Active NPI
Manal H Assaad
- Specialist
- Canton, OH
National Provider Identifier
1164669065
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 35074361
- Legal business name
- MANAL H ASSAAD
- Practice address
- 4360 Fulton Dr NW
Suite a
Canton, OH 44718-2878 - Phone
- (330) 433-0000
- NPI assigned
- Jan 14, 2009
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Bonnie Truett
- Title
- Office Manager
- Phone
- (330) 433-0000
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 35074361 | OH | Primary |
Addresses
Primary practice location
4360 Fulton Dr NW
Suite a
Canton, OH 44718-2878
Mailing address
4360 Fulton Dr NW
Suite a
Canton, OH 44718-2878
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2127559 | Medicaid | OH |
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1231891200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1403136000000",
"number": "1164669065",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4360 FULTON DR NW",
"address_2": "SUITE A",
"city": "CANTON",
"state": "OH",
"postal_code": "447182878"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4360 FULTON DR NW",
"address_2": "SUITE A",
"city": "CANTON",
"state": "OH",
"postal_code": "447182878",
"telephone_number": "330-433-0000"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MANAL H ASSAAD",
"organizational_subpart": "NO",
"enumeration_date": "2009-01-14",
"last_updated": "2014-06-19",
"status": "A",
"authorized_official_last_name": "TRUETT",
"authorized_official_first_name": "BONNIE",
"authorized_official_title_or_position": "OFFICE MANAGER",
"authorized_official_telephone_number": "330-433-0000"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Specialist",
"state": "OH",
"license": "35074361",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2127559",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Canton, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.