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NPI Code Detail

MEDICARE: DR. AHMAD KHAYAT MD

MEDICARE: DR. AHMAD KHAYAT MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RP1001XPulmonary Disease Physician4301071052MI
2207RP1001XPulmonary Disease Physician42686-20WI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1619084142
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. AHMAD KHAYAT MD
Provider Business Mailing Address
First Line : PO BOX 735044
Second Line :
City : CHICAGO
State : IL
Zip : 60673-5044
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3003 UNIVERSITY DR
Second Line :
City : MARINETTE
State : WI
Zip : 54143-4110
Country : US
Telephone Number : 715-735-4690
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/23/2006
Last Update Date : 11/10/2023

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