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General NPI Number Information
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NPI Number | 1912950544
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Entity Type | Organization
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Legal Business Name | MOHEB KHOUZAM, MD
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Dates
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Enumeration Date | 05/17/2006
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 135 MAIN ST
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City | DELHI
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State | NY
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Zip | 13753-1219
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Country | US
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Telephone | 607-746-9801
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Fax | 607-746-9802
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Provider Business Mailing Address
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Address Line | PO BOX 340
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City | NEW HARTFORD
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State | NY
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Zip | 13413-0340
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Country | US
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Telephone | 315-732-9368
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Fax | 315-732-9403
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Authorized Official
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Title or Position | SOLE PROPRIETOR
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Name | MOHEB KHOUZAM
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Credential | MD
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Telephone | 607-746-9801
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 189174-1
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 189174-1
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License Number State | NY
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