Healthcare Provider Details

I. General information

NPI: 1659681351
Provider Name (Legal Business Name): KARIM A. EL-KERSH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/14/2010
Last Update Date: 11/20/2023
Certification Date: 11/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 S JACKSON ST # A3R40 AMBULATORY CARE BUILDING
LOUISVILLE KY
40202-1622
US

IV. Provider business mailing address

755 E MCDOWELL RD
PHOENIX AZ
85006-2506
US

V. Phone/Fax

Practice location:
  • Phone: 502-852-5841
  • Fax:
Mailing address:
  • Phone: 602-521-3400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number69973
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number69973
License Number StateAZ
# 3
Primary TaxonomyN
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License Number69973
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: