Provider Demographics
NPI:1427670439
Name:ARIDI, HUSSAM (MD)
Entity type:Individual
Prefix:MR
First Name:HUSSAM
Middle Name:
Last Name:ARIDI
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 1:200 EUCLID AVE APT 547
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44114-2302
Mailing Address - Country:US
Mailing Address - Phone:929-428-3250
Mailing Address - Fax:
Practice Address - Street 1:95 ARCH ST STE 300
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44304-1473
Practice Address - Country:US
Practice Address - Phone:330-253-8195
Practice Address - Fax:330-253-0853
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-13
Last Update Date:2024-06-26
Deactivation Date:2022-01-17
Deactivation Code:
Reactivation Date:2022-02-08
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Single Specialty