Basic Information
| Provider Information | |||||||||
| NPI: | 1780068031 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ABDULRAHMAN | ||||||||
| FirstName: | KHALID DOUSA | ||||||||
| MiddleName: | |||||||||
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| Credential: | MD, CABIM | ||||||||
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| OtherLastName: | DOUSA | ||||||||
| OtherFirstName: | KHALID | ||||||||
| OtherMiddleName: | M. | ||||||||
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| OtherCredential: | MD | ||||||||
| OtherLastNameType: | 2 | ||||||||
| Mailing Information | |||||||||
| Address1: | 11100 EUCLID AVE | ||||||||
| Address2: | UNIVERSITY HOSPITALS CASE MEDICAL CENTER | ||||||||
| City: | CLEVELAND | ||||||||
| State: | OH | ||||||||
| PostalCode: | 441061716 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 11100 EUCLID AVE | ||||||||
| Address2: | UNIVERSITY HOSPITALS CASE MEDICAL CENTER | ||||||||
| City: | CLEVELAND | ||||||||
| State: | OH | ||||||||
| PostalCode: | 441061716 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2168441000 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/16/2015 | ||||||||
| LastUpdateDate: | 12/07/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 12/07/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RI0200X | 35.136202 | OH | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Infectious Disease |
No ID Information.