Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 88982 | OH |
Y | 208600000X | Surgeon | 88982 | OH |
N | 2082S0105X | Plastic Hand Surgeon | 88982 | OH |
NPI | 1851415798 |
---|---|
Provider Name | Dr. Habib Joseph Khoury |
First Address | Rocky River, OH 44116-3437 |
Second Address | Westlake, OH 44145-4141 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/03/2007 |
Last Update Date | 14/06/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000518761 | ANTHEM (01) | |
1780634279 | GROUP NPI (01) | |
2741779 | (05) | OH |
341783789127 | CARESOURCE (01) | |
3610861 | ASC MEDICARE GRP # (01) | |
7619947 | AETNA (01) | |
9273172 | MEDICARE PHY GROUP # (01) | |
CA4511 | RR MEDICARE GROUP # (01) | |
D368301 | MEDICARE GRP IND LAB (01) |