MEDICARE: DALIA S ELKHAIRI MD

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	207V00000X	Obstetrics & Gynecology Physician	38967	KY

Other Identifiers

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

General Provider Information

NPI Number	:	1942249735
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DALIA S ELKHAIRI MD

Provider Business Mailing Address
First Line	:	1 HEALTHY PL
Second Line	:	SUITE 201
City	:	PATASKALA
State	:	OH
Zip	:	43062-7067
Country	:	US
Telephone Number	:	740-348-1920
Fax Number	:	740-348-1921

Provider Business Practice Location Address
First Line	:	1 HEALTHY PL
Second Line	:	SUITE 201
City	:	PATASKALA
State	:	OH
Zip	:	43062-7067
Country	:	US
Telephone Number	:	740-348-1920
Fax Number	:	740-348-1921

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

Provider Enumeration Date	:	06/06/2006
Last Update Date	:	09/26/2011

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Directions to “ DALIA S ELKHAIRI MD” Practice Location

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