Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | 35056095 | OH |
NPI | 1346345725 |
---|---|
Provider Name | Oscar Fouad Khawli |
First Address | Boardman, OH 44512-6778 |
Second Address | Boardman, OH 44512-6778 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/09/2006 |
Last Update Date | 28/12/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0682560 | (05) | OH |
A17149 | (02) | |
H149710 | MEDICARE PTAN (01) | OH |