Individual
DR. NIDAA KHAMOUSIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
6450 WHEATSTONE CT, MAUMEE, OH 43537-9402
(419) 866-6200
(419) 866-7170
Mailing address
6450 WHEATSTONE CT, MAUMEE, OH 43537-9402
(419) 866-6200
(419) 866-7170
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
35087356
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2633396
—
OH
Enumeration date
04/11/2006
Last updated
05/09/2016
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