Provider Demographics
NPI:1497648240
Name:ALKHATIB, NOUWAR
Entity type:Individual
Prefix:
First Name:NOUWAR
Middle Name:
Last Name:ALKHATIB
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20005 FARNSLEIGH RD APT 112
Mailing Address - Street 2:
Mailing Address - City:SHAKER HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44122-3702
Mailing Address - Country:US
Mailing Address - Phone:206-402-8800
Mailing Address - Fax:
Practice Address - Street 1:22901 MILLCREEK BLVD STE 200
Practice Address - Street 2:
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122-5701
Practice Address - Country:US
Practice Address - Phone:216-727-0234
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-30
Last Update Date:2025-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRES.004943390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program