MEDICARE: KHALEEL QUSSOUS M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2080P0214X	Pediatric Pulmonology Physician	4301117316	MI
2	2080P0214X	Pediatric Pulmonology Physician	35.144382	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1114473832
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KHALEEL QUSSOUS M.D.

Provider Business Mailing Address
First Line	:	700 CHILDRENS DR
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43205-2639
Country	:	US
Telephone Number	:	614-722-2000
Fax Number	:

Provider Business Practice Location Address
First Line	:	2222 CHERRY ST STE 2900
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43608-2675
Country	:	US
Telephone Number	:	419-251-6430
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/01/2016
Last Update Date	:	03/03/2026

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Directions to “ KHALEEL QUSSOUS M.D.” Practice Location

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