Healthcare Provider Details

I. General information

NPI: 1821813445
Provider Name (Legal Business Name): KHALID D VOLIOUS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/19/2024
Last Update Date: 11/19/2024
Certification Date: 11/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5982 RHODES RD
KENT OH
44240-8100
US

IV. Provider business mailing address

251 SPAULDING DR APT 203
KENT OH
44240-1904
US

V. Phone/Fax

Practice location:
  • Phone: 330-298-8700
  • Fax:
Mailing address:
  • Phone: 234-788-9354
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: