MEDICARE: DR. ALI A EL-KHALIL DPM

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	213ES0103X	Foot & Ankle Surgery Podiatrist	5901002172	MI

General Provider Information

NPI Number	:	1669678462
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALI A EL-KHALIL DPM

Provider Business Mailing Address
First Line	:	5830 GOLFVIEW DR
Second Line	:
City	:	DEARBORN HEIGHTS
State	:	MI
Zip	:	48127-2483
Country	:	US
Telephone Number	:	305-926-0111
Fax Number	:	305-926-0111

Provider Business Practice Location Address
First Line	:	24327 FORD RD
Second Line	:
City	:	DEARBORN
State	:	MI
Zip	:	48128-1129
Country	:	US
Telephone Number	:	313-730-9260
Fax Number	:	313-359-9172

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

Provider Enumeration Date	:	06/27/2007
Last Update Date	:	11/21/2015

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