Bg Antar, Llc | |
11716 Detroit Ave Lakewood OH 44107-3002 | |
(440) 315-1489 | |
Not Available |
Full Name | Bg Antar, Llc |
---|---|
Speciality | Family Medicine |
Location | 11716 Detroit Ave, Lakewood, Ohio |
Authorized Official Name and Position | Mohammed Freddie Ahmad (OWNER) |
Authorized Official Contact | 4403151489 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Bg Antar, Llc Po Box 770800 Lakewood OH 44107-0037 Ph: (440) 315-1489 | Bg Antar, Llc 11716 Detroit Ave Lakewood OH 44107-3002 Ph: (440) 315-1489 |
NPI Number | 1588113211 |
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Provider Enumeration Date | 09/22/2016 |
Last Update Date | 07/21/2022 |
Identifier | Type | State | Issuer |
---|---|---|---|
1588113211 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | 35124466 (Ohio) | Primary |
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