MEDICARE: NORMAN P KHOURY 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	208600000X	Surgery Physician	8395	SC

General Provider Information

NPI Number	:	1760591812
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NORMAN P KHOURY M.D.

Provider Business Mailing Address
First Line	:	1240 HOSPITAL DR
Second Line	:
City	:	MOUNT PLEASANT
State	:	SC
Zip	:	29464-3251
Country	:	US
Telephone Number	:	843-884-2247
Fax Number	:	843-881-0653

Provider Business Practice Location Address
First Line	:	1240 HOSPITAL DR
Second Line	:
City	:	MOUNT PLEASANT
State	:	SC
Zip	:	29464-3251
Country	:	US
Telephone Number	:	843-884-2247
Fax Number	:	843-881-0653

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

Provider Enumeration Date	:	08/30/2006
Last Update Date	:	07/08/2007

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