Organization
M.STEVEN KHOURY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK KHOURY D.P.M. (PHYSICIAN)
(989) 673-3338
Entity
Organization
Contact information
Practice address
150 MILLWOOD ST, SUITE A, CARO, MI 48723-1656
(989) 673-3338
(989) 673-0112
Mailing address
P.O. BOX 349, 150 MILLWOOD ST., SUITE A, CARO, MI 48744-1656
(989) 673-3338
(989) 673-0112
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
MK001200
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2828096
—
MI
Enumeration date
06/27/2006
Last updated
08/30/2013
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