Individual
KHALLAD A FARES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
800 ZEAGLER DR, SUITE 320, PALATKA, FL 32177-3883
(386) 328-9977
(386) 329-1953
Mailing address
800 ZEAGLER DR, SUITE 320, PALATKA, FL 32177-3883
(386) 328-9977
(386) 329-1953
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
ME75536
FL
Other
Enumeration date
03/14/2006
Last updated
07/08/2007
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