Individual
HANI SHABAN ALKHATIB
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MB, BCH
Contact information
Practice address
1900 CENTRACARE CIR, #1600, CENTRACARE CLINIC HEALTH PLAZA SPECIALTY/ONCOLOGY, ST CLOUD, MN 56303
(320) 229-4907
(320) 229-5160
Mailing address
1900 CENTRACARE CIR, #1600, CENTRACARE CLINIC HEALTH PLAZA SPECIALTY/ONCOLOGY, ST CLOUD, MN 56303
(320) 229-4907
(320) 229-5160
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
34615
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
009517600
MEDICAL ASSISTANCE
—
05
—
009517600
—
MN
01
—
05T20AL
BLUE CROSS BLUE SHIELD
—
01
—
1001406
PREFERRED ONE
—
01
—
112085
U CARE
—
01
—
20111
ARAZ GRP AMERICA'S PPO
—
01
—
2129263
FIRST HEALTH PLAN
—
01
—
3600190
MEDICA HEALTH PLANS
—
01
—
499R1KH
BLUE CROSS BLUE SHIELD
—
01
—
830000282
MEDICARE
—
01
—
900000917
RR MEDICARE
—
01
—
HP27008
HEALTH PARTNERS
—
Enumeration date
11/04/2005
Last updated
03/11/2010
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