Healthcare Provider Details

I. General information

NPI: 1457357295
Provider Name (Legal Business Name): ZIAD KHOURY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/27/2005
Last Update Date: 08/07/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1915 VALLEY VIEW BLVD
ALTOONA PA
16602-6527
US

IV. Provider business mailing address

914 S 12TH ST
ALTOONA PA
16602-6247
US

V. Phone/Fax

Practice location:
  • Phone: 814-201-2309
  • Fax: 814-201-2389
Mailing address:
  • Phone: 814-201-2309
  • Fax: 814-201-2389

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberMD053122L
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License NumberMD053122L
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code207UN0901X
TaxonomyNuclear Cardiology Physician
License NumberMD053122L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: