MEDICARE: AMIN YOUSSEF KHALIL 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	207R00000X	Internal Medicine Physician	35077196	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	22639	OTHER	OH	QUALCHOICE
2	101425	OTHER	OH	BLACK LUNG
3	341960347	OTHER	OH	AETNA
4	341960347A	OTHER	OH	AULTCARE
5	174396	OTHER	OH	HIGHMARK BC/BS
6	1962238	OTHER	OH	FIRST HEALTH NETWORK
7	340960347	OTHER	OH	SUMMA
8	000000213674	OTHER	OH	ANTHEM
9	104450	OTHER	OH	KAISER PERMANENTE
10	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
11	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
12	341960347	OTHER	OH	CIGNA

General Provider Information

NPI Number	:	1700867959
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMIN YOUSSEF KHALIL M.D.

Provider Business Mailing Address
First Line	:	855 W MAPLE ST
Second Line	:	HARTVILLE
City	:	HARTVILLE
State	:	OH
Zip	:	44632-9668
Country	:	US
Telephone Number	:	330-877-9388
Fax Number	:	330-488-2907

Provider Business Practice Location Address
First Line	:	855 W MAPLE ST
Second Line	:	HARTVILLE
City	:	HARTVILLE
State	:	OH
Zip	:	44632-9668
Country	:	US
Telephone Number	:	330-877-9388
Fax Number	:	330-488-2907

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

Provider Enumeration Date	:	11/07/2005
Last Update Date	:	02/17/2011

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Directions to “ AMIN YOUSSEF KHALIL M.D.” Practice Location

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