Individual
HISHAM AHMED KHADR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2301 E ALLEGHENY AVE, NORTHEASTERN HOSPITAL, PHILADELPHIA, PA 19134-4427
(215) 423-2376
(215) 634-4872
Mailing address
PO BOX 820956, TEMPLE PHYSICIANS INC, PHILADELPHIA, PA 19182-0956
(800) 777-2455
(610) 617-6820
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MD041099L
PA
207R00000X
Internal Medicine Physician
MD041099L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0011504880009
—
PA
Enumeration date
07/06/2006
Last updated
01/12/2015
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