Provider Demographics
NPI:1861412520
Name:TAHIR, MOHAMMAD I (MD)
Entity type:Individual
Prefix:
First Name:MOHAMMAD
Middle Name:I
Last Name:TAHIR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24701 EUCLID AVE
Mailing Address - Street 2:
Mailing Address - City:EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44117-1714
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:11100 EUCLID AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44106-1716
Practice Address - Country:US
Practice Address - Phone:216-844-1636
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2011-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-073573207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000221368OtherUNISON
OHP00275200OtherRAILROAD MEDICARE
OH7108181OtherAETNA
OHP00366732OtherMEDICARE RAILROAD
OH2151586Medicaid
OH364069OtherWELLCARE MEDICAID
OH000000503547OtherANTHEM
OH747147OtherBUCKEYE MEDICAID
H03841Medicare UPIN
OH7108181OtherAETNA
OHTA0891037Medicare PIN