Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0000X | Internist - Cardiovascular Disease | TRN10078 | FL |
Y | 207RC0001X | Clinical Cardiac Electrophysiologist | MD15198R | LA |
NPI | 1154491819 |
---|---|
Provider Name | Sammy Khatib |
First Address | New Orleans, LA 70121 |
Second Address | New Orleans, LA 70121 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/11/2006 |
Last Update Date | 15/01/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00757260 | (05) | MS |
1058360 | (05) | LA |