Healthcare Provider Details

I. General information

NPI: 1871143768
Provider Name (Legal Business Name): KHALED NASR YOUSEF GHARAIBEH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/12/2019
Last Update Date: 02/25/2026
Certification Date: 02/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2109 HUGHES DR # 810
TOLEDO OH
43606-3858
US

IV. Provider business mailing address

2109 HUGHES DR # 810
TOLEDO OH
43606-3858
US

V. Phone/Fax

Practice location:
  • Phone: 419-291-2014
  • Fax: 419-479-6094
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084V0102X
TaxonomyVascular Neurology Physician
License Number35.148105
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: