Individual
MARK H KHALILI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
835 SWEITZER ST, GREENVILLE, OH 45331-1007
(937) 548-1141
Mailing address
835 SWEITZER ST, GREENVILLE, OH 45331-1007
(937) 548-1141
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
35079468
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000342339
ANTHEM ER
OH
01
—
000000342356
ANTHEM CCC
OH
01
—
1995899500
BWC
OH
05
—
2300790
—
OH
01
—
3903304
UHC CCC
OH
01
—
3920481
UHC ER
OH
Enumeration date
06/23/2006
Last updated
07/09/2007
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