Provider Demographics
NPI:1548902018
Name:ABI-RACHED, JOHNNY DEEB (DO)
Entity type:Individual
Prefix:
First Name:JOHNNY
Middle Name:DEEB
Last Name:ABI-RACHED
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8000 5 MILE RD STE 100
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45230-2187
Mailing Address - Country:US
Mailing Address - Phone:513-233-6978
Mailing Address - Fax:
Practice Address - Street 1:8000 5 MILE RD STE 100
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45230-2187
Practice Address - Country:US
Practice Address - Phone:513-233-6978
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-13
Last Update Date:2022-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program