Healthcare Provider Details

I. General information

NPI: 1396193009
Provider Name (Legal Business Name): ARIF OMAR KHAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/03/2016
Last Update Date: 06/03/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

OPHTHALMOLOGY COLE EYE INSTITUTE I30 9500 EUCLID AVE
CLEVELAND OH
44195-0001
US

IV. Provider business mailing address

EYE INSTITUTE, CLEVELAND CLINIC ABU DHABI PO BOX 112412
ABU DHABI UAE
0
AE

V. Phone/Fax

Practice location:
  • Phone: 216-444-5892
  • Fax:
Mailing address:
  • Phone: 97125019000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number072621
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: