Provider Demographics
NPI:1205833084
Name:KHOURI, AMER (MD)
Entity Type:Individual
Prefix:
First Name:AMER
Middle Name:
Last Name:KHOURI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3730 PLAZA WAY STE 6200
Mailing Address - Street 2:
Mailing Address - City:KENNEWICK
Mailing Address - State:WA
Mailing Address - Zip Code:99338-2718
Mailing Address - Country:US
Mailing Address - Phone:509-221-2449
Mailing Address - Fax:509-221-2433
Practice Address - Street 1:3730 PLAZA WAY STE 6200
Practice Address - Street 2:
Practice Address - City:KENNEWICK
Practice Address - State:WA
Practice Address - Zip Code:99338-2718
Practice Address - Country:US
Practice Address - Phone:509-221-2449
Practice Address - Fax:509-221-2433
Is Sole Proprietor?:No
Enumeration Date:2005-07-07
Last Update Date:2020-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD 60574057207RH0003X
PAMD056597L207RX0202X
OH35-120820207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA000958921OtherHIGHMARK
OH0087533Medicaid
PA0016523450009Medicaid
PAP00463120Medicare PIN
OHH237960Medicare PIN
PA0016523450009Medicaid
PA000958921OtherHIGHMARK