Healthcare Provider Details

I. General information

NPI: 1447289988
Provider Name (Legal Business Name): AHMED KHALIL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: AHMED MOHAMED KHALIL MD

II. Dates (important events)

Enumeration Date: 06/30/2006
Last Update Date: 03/21/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

234 GOODMAN ST
CINCINNATI OH
45219-2364
US

IV. Provider business mailing address

234 GOODMAN ST
CINCINNATI OH
45219-2364
US

V. Phone/Fax

Practice location:
  • Phone: 513-585-5502
  • Fax: 513-585-5511
Mailing address:
  • Phone: 513-475-8922
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number35081897
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: