Individual
OSAMA KHALED ALI KADDOURAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1640 WOODBROOKE DR, SALISBURY, MD 21804-8501
(410) 912-5640
Mailing address
1640 WOODBROOKE DR, SALISBURY, MD 21804-8501
(410) 912-5640
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
2015017267
MO
207RG0100X
Gastroenterology Physician
2015017267
MO
207RG0100X
Gastroenterology Physician
Primary
D0092318
MD
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/10/2015
Last updated
08/31/2021
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