Provider Demographics
NPI:1871143768
Name:GHARAIBEH, KHALED NASR YOUSEF (MD)
Entity type:Individual
Prefix:
First Name:KHALED
Middle Name:NASR YOUSEF
Last Name:GHARAIBEH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4430 N HOLLAND SYLVANIA RD APT 4307
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43623-3556
Mailing Address - Country:US
Mailing Address - Phone:419-450-8873
Mailing Address - Fax:
Practice Address - Street 1:4430 N HOLLAND SYLVANIA RD APT 4307
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43623-3556
Practice Address - Country:US
Practice Address - Phone:419-450-8873
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-12
Last Update Date:2019-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program