Individual
DR. KEVIN A KHATER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD, PHD
Contact information
Practice address
6308 8TH AVE, KENOSHA, WI 53143-5031
(262) 577-8206
(262) 577-8587
Mailing address
6308 8TH AVE, KENOSHA, WI 53143-5031
(262) 577-8206
(262) 577-8587
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
01063742A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200860960
—
IN
Enumeration date
05/15/2006
Last updated
06/26/2015
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