Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 2010025665 | MO |
N | 111NI0900X | Internist | 2010025665 | MO |
N | 207RH0000X | Hematologist | 2010025665 | MO |
Y | 207RH0003X | Hematology & Oncology | 2010025665 | MO |
N | 207RX0202X | Medical Oncology | 2010025665 | MO |
NPI | 1225221021 |
---|---|
Provider Name | Dr. Radwan Faris Khozouz |
First Address | Columbia, MO 65201-5275 |
Second Address | Columbia, MO 65201-5275 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/08/2007 |
Last Update Date | 10/11/2021 |