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Individual
ADEL KHDOUR
Active
Individual
ADEL KHDOUR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
01064330A
IN
207Q00000X
Family Medicine Physician
036118811
IL
207Q00000X
Family Medicine Physician
Primary
81805
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000531548
ANTHEM PROVIDER NUMBER
IN
01
—
000001014115
ANTHEM PIN - URGENT CARE UNDER TIN 35-2030653
IN
05
—
100251357
—
WI
05
—
200876650
—
IN
Enumeration date
08/10/2007
Last updated
10/16/2023
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