Individual
DR. KHALED ISSA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
30701 CLEMENS RD, WESTLAKE, OH 44145-1074
(440) 617-1212
(440) 617-1213
Mailing address
30701 CLEMENS ROAD, WESTLAKE, OH 44145
(440) 617-1212
(440) 617-1213
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
35058319
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0844439
—
OH
01
—
100014941
RAILROAD MEDICARE
OH
Enumeration date
07/24/2006
Last updated
08/12/2015
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