Individual
KHALIL ODEH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
945 N 12TH ST, MILWAUKEE, WI 53233-1305
(414) 219-7635
Mailing address
945 N 12TH ST, MILWAUKEE, WI 53233-1305
(414) 219-2000
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
71227-20
WI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100102941
—
WI
Enumeration date
03/21/2017
Last updated
02/12/2026
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