Individual
DR. AHMED A KHALAFALLAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
600 JOHN DEERE ROAD, SUITE 200, MOLINE, IL 61265-6897
(309) 779-4200
(309) 779-4305
Mailing address
600 JOHN DEERE ROAD, SUITE 200, MOLINE, IL 61265-6897
(309) 779-4200
(309) 779-4305
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036087228
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010065270
RR MEDICARE
IL
05
—
036087228
—
IL
Enumeration date
01/25/2006
Last updated
06/11/2008
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