MEDICARE: KAMAL KHALAFI 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	35074605K	OH

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	1992791263	OTHER		NPI

General Provider Information

NPI Number	:	1992791263
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAMAL KHALAFI M.D.

Provider Business Mailing Address
First Line	:	PO BOX 391405
Second Line	:
City	:	SOLON
State	:	OH
Zip	:	44139-8405
Country	:	US
Telephone Number	:	216-491-7660
Fax Number	:	216-491-7662

Provider Business Practice Location Address
First Line	:	4200 WARRENSVILLE CENTER RD
Second Line	:	SUITE 430
City	:	BEACHWOOD
State	:	OH
Zip	:	44122-7051
Country	:	US
Telephone Number	:	216-491-7660
Fax Number	:	216-491-7662

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

Provider Enumeration Date	:	09/22/2005
Last Update Date	:	06/22/2015

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Directions to “ KAMAL KHALAFI M.D.” Practice Location

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