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General NPI Number Information
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NPI Number | 1821127564
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Entity Type | Individual
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Provider Name | CHARLES M KHALIL D.P.M.
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Gender | Male
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Dates
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Enumeration Date | 03/05/2007
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Last Update Date | 10/10/2011
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Provider Practice Location Address
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Address Line | 22770 KELLY RD #3
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City | EASTPOINTE
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State | MI
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Zip | 48021-2009
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Country | US
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Telephone | 586-447-4900
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Fax | 586-447-0024
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Provider Business Mailing Address
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Address Line | 22770 KELLY RD #3
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City | EASTPOINTE
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State | MI
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Zip | 48021-2009
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Country | US
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Telephone | 586-447-4900
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Fax | 586-447-0024
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | CK001653
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License Number State | MI
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