Healthcare Provider Details

I. General information

NPI: 1497967863
Provider Name (Legal Business Name): KHALID ALMUTI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/05/2007
Last Update Date: 06/15/2022
Certification Date: 06/15/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7502 STATE RD STE 2210A
CINCINNATI OH
45255-2596
US

IV. Provider business mailing address

7502 STATE RD STE 2210A
CINCINNATI OH
45255-2596
US

V. Phone/Fax

Practice location:
  • Phone: 513-624-2070
  • Fax: 513-624-2077
Mailing address:
  • Phone: 513-624-2070
  • Fax: 513-624-2077

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberMT187642
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License Number35.095381
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberMD432097
License Number StatePA
# 4
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number35.095381
License Number StateOH
# 5
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number35.095381
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: