=====================================================
General NPI Number Information
=====================================================
NPI Number | 1629936018
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | DR. MICHAEL MAHER FAHMY KHALIL
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/13/2026
-----------------------------------------------------
Last Update Date | 01/13/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2138 VETERANS PKWY
-----------------------------------------------------
City | CLAYTON
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 27520-5300
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 919-585-8000
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4634 WEDGEWOOD DR
-----------------------------------------------------
City | RALEIGH
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 27604-4998
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 919-607-8415
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 246ZX2200X
-----------------------------------------------------
Taxonomy Name | Orthopedic Assistant
-----------------------------------------------------
License Number | 0136001050
-----------------------------------------------------
License Number State | VA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 246ZC0007X
-----------------------------------------------------
Taxonomy Name | Surgical Assistant
-----------------------------------------------------
License Number | 0136001050
-----------------------------------------------------
License Number State | VA
-----------------------------------------------------