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1356345193

NPI Code Detail

MEDICARE: KOROUSH KHALIGHI M.D.

MEDICARE: KOROUSH KHALIGHI 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	207RC0000X	Cardiovascular Disease Physician	25MA056515	NJ
2	207RC0000X	Cardiovascular Disease Physician	MD066096-L	PA
3	207RC0001X	Clinical Cardiac Electrophysiology Physician	25MA068440	NJ
4	207RC0001X	Clinical Cardiac Electrophysiology Physician	102020	WI
5	207UN0901X	Nuclear Cardiology Physician	MD041360-L	PA
6	207UN0901X	Nuclear Cardiology Physician	25MA056515	NJ
7	207RC0001X	Clinical Cardiac Electrophysiology Physician	MD041360-L	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2026901	OTHER	PA	CAPITAL BLUE CROSS
2	674485	OTHER	PA	KEYSTONE CAPITAL
3	9051056	OTHER	PA	CIGNA PA
4	P718311	OTHER	PA	OXFORD
5	1459106	OTHER	PA	HIGHMARK PA
6	563332	OTHER	PA	AETNA US HEALTHCARE
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
8	674485	OTHER	NJ	HIGHMARK NJ
9	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
10	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1356345193
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KOROUSH KHALIGHI M.D.

Provider Business Mailing Address
First Line	:	PO BOX 783311
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19178-3311
Country	:	US
Telephone Number	:	484-884-4500
Fax Number	:	484-884-0699

Provider Business Practice Location Address
First Line	:	122 WYOMING STREET
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45409-2731
Country	:	US
Telephone Number	:	937-223-4461
Fax Number	:

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

Provider Enumeration Date	:	06/09/2005
Last Update Date	:	04/16/2025

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Directions to “ KOROUSH KHALIGHI M.D.” Practice Location

Language	Start Address	Practice Location

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