Provider Demographics
NPI:1699885996
Name:AITI, MOHAMMED YASSER (MD)
Entity type:Individual
Prefix:
First Name:MOHAMMED
Middle Name:YASSER
Last Name:AITI
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 1:344 GAIL AVE NE
Mailing Address - Street 2:
Mailing Address - City:MASSILLON
Mailing Address - State:OH
Mailing Address - Zip Code:44646-8901
Mailing Address - Country:US
Mailing Address - Phone:330-837-4938
Mailing Address - Fax:330-830-0133
Practice Address - Street 1:344 GAIL AVE NE
Practice Address - Street 2:
Practice Address - City:MASSILLON
Practice Address - State:OH
Practice Address - Zip Code:44646-8901
Practice Address - Country:US
Practice Address - Phone:330-837-4938
Practice Address - Fax:330-830-0133
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35 048353207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0815658Medicaid
OH0683253Medicare ID - Type Unspecified
OH0815658Medicaid