MEDICARE: MAI G AL KHADEM MD

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	208600000X	Surgery Physician	MD-56333	IA

General Provider Information

NPI Number	:	1134651979
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MAI G AL KHADEM MD

Provider Business Mailing Address
First Line	:	2730 PIERCE ST STE 420
Second Line	:
City	:	SIOUX CITY
State	:	IA
Zip	:	51104-3796
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2730 PIERCE ST STE 420
Second Line	:
City	:	SIOUX CITY
State	:	IA
Zip	:	51104-3796
Country	:	US
Telephone Number	:	712-234-8725
Fax Number	:

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

Provider Enumeration Date	:	03/31/2017
Last Update Date	:	03/24/2026

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Directions to “ MAI G AL KHADEM MD” Practice Location

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