Khaled Khaled Abdel Aziz Jr.

Individual provider Active NPI Student in an Organized Health Care Education/Training Program · Cincinnati, OH

NPI 1730949041 · NPPES record last updated Mar 21, 2024

Key facts

NPI
1730949041
Entity type
Individual (NPI type 1)
Primary specialty
Student in an Organized Health Care Education/Training Program 390200000X
Practice address
3188 Bellevue Ave
ML 0781
Cincinnati, OH 45219
Phone
(513) 584-4505
Fax
(513) 584-0468
NPI assigned
Mar 21, 2024
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20241105002571 OH Order and Referring Only - Internal Medicine
Practitioner - Internal Medicine
8921532557

National Provider Directory

Medicare enrollment (NPD)
Yes

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Yes

Addresses

Primary practice location

3188 Bellevue Ave
ML 0781
Cincinnati, OH 45219

Mailing address

3188 Bellevue Ave
ML 0781
Cincinnati, OH 45219
Phone (513) 584-4505

Other providers in Cincinnati, OH

All providers in Cincinnati, OH · Student in an Organized Health Care Education/Training Program in Ohio

Sources for this page

Verify at the official NPI Registry.