Individual
DR. HABIB JOSEPH KHOURY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
25200 CENTER RIDGE RD, #3300, WESTLAKE, OH 44145-4141
(440) 331-3645
Mailing address
20525 CENTER RIDGE RD, SUITE 220, ROCKY RIVER, OH 44116-3437
(440) 895-5056
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
88982
OH
2082S0099X
Plastic Surgery Within the Head and Neck (Plastic Surgery) Physician
88982
OH
2082S0105X
Surgery of the Hand (Plastic Surgery) Physician
88982
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000518761
ANTHEM
—
01
—
1780634279
GROUP NPI
—
05
—
2741779
—
OH
01
—
341783789127
CARESOURCE
—
01
—
3610861
ASC MEDICARE GRP #
—
01
—
7619947
AETNA
—
01
—
9273172
MEDICARE PHY GROUP #
—
01
—
CA4511
RR MEDICARE GROUP #
—
01
—
D368301
MEDICARE GRP IND LAB
—
Enumeration date
03/17/2007
Last updated
06/14/2012
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