Provider Demographics
NPI:1447289988
Name:KHALIL, AHMED (MD)
Entity type:Individual
Prefix:
First Name:AHMED
Middle Name:
Last Name:KHALIL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:AHMED
Other - Middle Name:MOHAMED
Other - Last Name:KHALIL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:234 GOODMAN ST
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45219-2364
Mailing Address - Country:US
Mailing Address - Phone:513-475-8922
Mailing Address - Fax:
Practice Address - Street 1:234 GOODMAN ST
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45219-2364
Practice Address - Country:US
Practice Address - Phone:513-585-5502
Practice Address - Fax:513-585-5511
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-30
Last Update Date:2019-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35081897207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200481960Medicaid
KY64080518Medicaid
OH2478500Medicaid
OH2478500Medicaid
I06397Medicare UPIN