Basic Information
Provider Information
NPI: 1215961602
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ABDUL-KARIM
FirstName: FADI
MiddleName: W
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
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OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 24701 EUCLID AVE
Address2: 3RD FLOOR
City: EUCLID
State: OH
PostalCode: 441171714
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 11100 EUCLID AVE
Address2:  
City: CLEVELAND
State: OH
PostalCode: 441061716
CountryCode: US
TelephoneNumber: 2168447494
FaxNumber: 2162866341
Other Information
ProviderEnumerationDate: 07/10/2006
LastUpdateDate: 08/17/2010
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207ZP0101X35-053198OHY Allopathic & Osteopathic PhysiciansPathologyAnatomic Pathology
207ZP0102X35-053198OHN Allopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
207ZB0001X35-053198OHN Allopathic & Osteopathic PhysiciansPathologyBlood Banking & Transfusion Medicine
207ZP0104X35-053198OHN Allopathic & Osteopathic PhysiciansPathologyChemical Pathology
207ZC0006X35-053198OHN Allopathic & Osteopathic PhysiciansPathologyClinical Pathology
207ZP0105X35-053198OHN Allopathic & Osteopathic PhysiciansPathologyClinical Pathology/Laboratory Medicine
207ZC0500X35-053198OHN Allopathic & Osteopathic PhysiciansPathologyCytopathology
207ZD0900X35-053198OHN Allopathic & Osteopathic PhysiciansPathologyDermatopathology
207ZF0201X35-053198OHN Allopathic & Osteopathic PhysiciansPathologyForensic Pathology
207ZH0000X35-053198OHN Allopathic & Osteopathic PhysiciansPathologyHematology
207ZI0100X35-053198OHN Allopathic & Osteopathic PhysiciansPathologyImmunopathology
207ZM0300X35-053198OHN Allopathic & Osteopathic PhysiciansPathologyMedical Microbiology
207ZP0007X35-053198OHN Allopathic & Osteopathic PhysiciansPathologyMolecular Genetic Pathology
207ZN0500X35-053198OHN Allopathic & Osteopathic PhysiciansPathologyNeuropathology
207ZP0213X35-053198OHN Allopathic & Osteopathic PhysiciansPathologyPediatric Pathology

ID Information
IDTypeStateIssuerDescription
36417201OHWELLCAREOTHER
00000052872501OHANTHEMOTHER
012746401OHBCMHOTHER
74380501OHBUCKEYEOTHER
P0041122301OHRAILROAD MEDICAREOTHER
00000003100901OHANTHEMOTHER
110037801OHUHCOTHER
00000022423701OHUNISONOTHER
012783905OH MEDICAID
063940601OHAETNAOTHER
22001581801OHRAILROAD MEDICAREOTHER


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