MEDICARE: MR. FERAS MOHAMMED KHMOUS

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	342000000X	Transportation Network Company	254665	OH

General Provider Information

NPI Number	:	1518650811
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. FERAS MOHAMMED KHMOUS

Provider Business Mailing Address
First Line	:	2042 CAMARO AVE
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43207-1715
Country	:	US
Telephone Number	:	614-696-4704
Fax Number	:

Provider Business Practice Location Address
First Line	:	2042 CAMARO AVE
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43207-1715
Country	:	US
Telephone Number	:	614-396-4704
Fax Number	:

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

Provider Enumeration Date	:	06/01/2023
Last Update Date	:	06/01/2023

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