Individual
GEORGE M KHURI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
15800 DETROIT AVE, STE 400, LAKEWOOD, OH 44107-3748
(216) 226-8700
(216) 221-3171
Mailing address
15800 DETROIT AVE, LAKEWOOD, OH 44107-3748
(216) 226-8700
(216) 221-3171
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
35074781K
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0119204
GROUP MEDICAID
—
01
—
10794268
CAQH
—
01
—
110244825
RR MEDICARE INDIVIDUAL
—
01
—
1780634279
GROUP NPI
—
05
—
2120323
—
OH
01
—
3610861
GROUP ASC MEDICARE
—
01
—
9273172
GROUP MEDICARE
—
01
—
CA4511
RR MEDICARE GROUP
—
01
—
D368301
GROUP IND DIAGNOSTICS MED
—
Enumeration date
03/07/2006
Last updated
03/28/2024
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