Individual
MOHAMED KHALIFA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
801 POLE LINE RD W, TWIN FALLS, ID 83301-5810
(208) 381-2645
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
MC-1489
ID
208000000X
Pediatrics Physician
Primary
S1427
TX
208M00000X
Hospitalist Physician
S1427
TX
282N00000X
General Acute Care Hospital
—
—
Other
Enumeration date
08/14/2014
Last updated
05/12/2023
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