Healthcare Provider Details

I. General information

NPI: 1881028306
Provider Name (Legal Business Name): RIHAM EL KHOULI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/03/2013
Last Update Date: 08/25/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 ROSE ST HX302
LEXINGTON KY
40536-0293
US

IV. Provider business mailing address

800 ROSE ST HX302
LEXINGTON KY
40536-0293
US

V. Phone/Fax

Practice location:
  • Phone: 443-929-1877
  • Fax:
Mailing address:
  • Phone: 443-929-1877
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207UN0902X
TaxonomyNuclear Imaging & Therapy Physician
License NumberTP230
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number3195
License Number StateMD
# 3
Primary TaxonomyY
Taxonomy Code207UN0902X
TaxonomyNuclear Imaging & Therapy Physician
License Number49511
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: