Provider Demographics
NPI:1407858061
Name:KANAAN, TARIF ADEL (MD)
Entity type:Individual
Prefix:
First Name:TARIF
Middle Name:ADEL
Last Name:KANAAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2409 CHERRY ST
Mailing Address - Street 2:STE 100
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43608-2625
Mailing Address - Country:US
Mailing Address - Phone:419-251-3700
Mailing Address - Fax:419-251-3835
Practice Address - Street 1:2409 CHERRY ST
Practice Address - Street 2:STE 100
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43608-2625
Practice Address - Country:US
Practice Address - Phone:419-251-3700
Practice Address - Fax:419-251-3835
Is Sole Proprietor?:No
Enumeration Date:2005-08-12
Last Update Date:2016-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35078241207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH04687OtherPARAMOUNT
OH2535233Medicaid
OH000000351947OtherANTHEM
MI4807040Medicaid
OH000000351947OtherANTHEM
OH$$$$$$$$$002OtherMEDICAL MUTUAL
OH04687OtherPARAMOUNT
MI4807040Medicaid