Basic Information
Provider Information
NPI: 1003000142
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: KHALIL
FirstName: RASHID
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2200 JEFFERSON AVE
Address2: 4TH FLOOR
City: TOLEDO
State: OH
PostalCode: 436047101
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 4126 N HOLLAND SYLVANIA RD
Address2: SUITE 220
City: TOLEDO
State: OH
PostalCode: 436233536
CountryCode: US
TelephoneNumber: 4195177624
FaxNumber: 4195177656
Other Information
ProviderEnumerationDate: 08/31/2007
LastUpdateDate: 08/03/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207L00000X35096817OHY Allopathic & Osteopathic PhysiciansAnesthesiology 
207LP2900X4301093657MIN Allopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine

ID Information
IDTypeStateIssuerDescription
005171205OH MEDICAID


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