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General NPI Number Information
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NPI Number | 1972675189
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Entity Type | Organization
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Legal Business Name | CHEST & SLEEP CONSULTANTS
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Dates
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Enumeration Date | 11/14/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 952 S STATE ROAD 2
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City | VALPARAISO
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State | IN
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Zip | 46385-6322
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Country | US
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Telephone | 219-465-6598
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Fax | 219-548-0598
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Provider Business Mailing Address
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Address Line | PO BOX 1483
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City | VALPARAISO
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State | IN
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Zip | 46384-1483
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Country | US
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Telephone | 219-465-6598
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Fax | 219-548-0598
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Authorized Official
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Title or Position | PRESIDENT
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Name | MOHAMMAD K KHEDR
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Credential | MD
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Telephone | 219-465-6598
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | 01058588
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License Number State | IN
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