Healthcare Provider Details

I. General information

NPI: 1194978627
Provider Name (Legal Business Name): MAY A AL-KHUNAIZI M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/28/2008
Last Update Date: 10/28/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

FAISAL BIN FAHAD ST
AL-KHOBAR SA
31952
SA

IV. Provider business mailing address

P.O. BOX 761
AL-QATEEF SA
31911
SA

V. Phone/Fax

Practice location:
  • Phone: 663-801-1011
  • Fax:
Mailing address:
  • Phone: 663-801-1011
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number154988
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: