Individual
SUHAIL H KHADRA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
10010 DONALD POWERS DR, MUNSTER, IN 46321
(219) 934-4210
(219) 934-4288
Mailing address
10010 DONALD POWERS DR, MUNSTER, IN 46321
(219) 934-4210
(219) 934-4288
Taxonomy
Speciality
Code
Description
License number
State
193400000X
Single Specialty Group
Primary
01075981A
IN
207R00000X
Internal Medicine Physician
036066290
IL
207RC0000X
Cardiovascular Disease Physician
036066290
IL
Other
Enumeration date
05/09/2006
Last updated
11/13/2015
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