Organization
KHOURY SURGICAL GROUP, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RAJAI T KHOURY MD (PRESIDENT)
(304) 233-2455
Entity
Organization
Contact information
Practice address
20 MEDICAL PARK, SUITE 203, WHEELING, WV 26003-6390
(304) 233-2455
(304) 233-6073
Mailing address
PO BOX 6780, WHEELING, WV 26003-0918
(304) 233-2455
(304) 233-6073
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
—
—
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0492766
—
OH
05
—
3810003359
—
WV
Enumeration date
01/10/2007
Last updated
10/18/2007
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