Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RH0003X | Hematology & Oncology | 0101235242 | VA |
N | 207RH0003X | Hematology & Oncology | 42603 | KY |
Y | 207RH0003X | Hematology & Oncology | 53593 | MN |
NPI | 1063513224 |
---|---|
Provider Name | Dr. Khalid Ali Kambal |
First Address | Hutchinson, MN 55350-5000 |
Second Address | Hutchinson, MN 55350-5000 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/09/2006 |
Last Update Date | 28/04/2011 |