Provider Demographics
NPI:1275509796
Name:ALAMIN, KHOSROW (MD)
Entity Type:Individual
Prefix:DR
First Name:KHOSROW
Middle Name:
Last Name:ALAMIN
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 1:5620 SOUTHWYCK BLVD
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43614-1501
Mailing Address - Country:US
Mailing Address - Phone:419-866-1804
Mailing Address - Fax:
Practice Address - Street 1:3131 QUEEN CITY AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45238-2316
Practice Address - Country:US
Practice Address - Phone:419-866-1804
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-24
Last Update Date:2008-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35028927207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0532052Medicaid
OHC00373Medicare UPIN
OHAL0523281Medicare PIN
OH0523281Medicare PIN