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General NPI Number Information
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NPI Number | 1114050499
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Entity Type | Organization
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Legal Business Name | RIAD G KHOURY PC
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Dates
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Enumeration Date | 03/14/2007
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Last Update Date | 05/06/2014
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Provider Practice Location Address
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Address Line | 28521 ORCHARD LAKE RD STE C
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City | FARMINGTON HILLS
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State | MI
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Zip | 48334-2934
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Country | US
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Telephone | 248-987-6190
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Fax | 248-987-6193
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Provider Business Mailing Address
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Address Line | 28521 ORCHARD LAKE RD SUITE C
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City | FARMINGTON HILLS
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State | MI
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Zip | 48334-2934
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Country | US
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Telephone | 248-987-6190
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Fax | 248-987-6193
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Authorized Official
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Title or Position | OWNER
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Name | RIAD G KHOURY
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Credential | MD
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Telephone | 248-987-6190
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | 4301038502
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License Number State | MI
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