Provider Demographics
NPI:1124101720
Name:YAMOUR, ADIL (MD)
Entity type:Individual
Prefix:DR
First Name:ADIL
Middle Name:
Last Name:YAMOUR
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 1:4 COMMERCIAL AVE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON COURT HOUSE
Mailing Address - State:OH
Mailing Address - Zip Code:43160-2197
Mailing Address - Country:US
Mailing Address - Phone:740-333-7507
Mailing Address - Fax:740-335-3124
Practice Address - Street 1:4 COMMERCIAL AVE
Practice Address - Street 2:
Practice Address - City:WASHINGTON COURT HOUSE
Practice Address - State:OH
Practice Address - Zip Code:43160-2197
Practice Address - Country:US
Practice Address - Phone:740-333-7507
Practice Address - Fax:740-335-3124
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-24
Last Update Date:2010-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-04-7500Y174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0489305Medicaid
OH0489305Medicaid
OHCO2311Medicare UPIN