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NPI Code Detail

MEDICARE: DR. ELIE JOSEPH KHOURI M.D

MEDICARE:  DR. ELIE JOSEPH KHOURI  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
1207R00000XInternal Medicine PhysicianME64138FL
2208M00000XHospitalist PhysicianME64138FL

Other Identifiers

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

General Provider Information

NPI Number : 1558324442
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ELIE JOSEPH KHOURI M.D
Provider Business Mailing Address
First Line : 3392 TABREEZE CT
Second Line :
City : OCOEE
State : FL
Zip : 34761-4600
Country : US
Telephone Number : 407-341-8970
Fax Number :
Provider Business Practice Location Address
First Line : 1701 LACEY ST
Second Line :
City : CAPE GIRARDEAU
State : MO
Zip : 63701-5230
Country : US
Telephone Number : 573-331-6431
Fax Number : 573-986-5984
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/11/2006
Last Update Date : 01/31/2013

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