Provider Demographics
NPI:1275607533
Name:AL-ZOUHAYLI, KHEIR (MD)
Entity Type:Individual
Prefix:
First Name:KHEIR
Middle Name:
Last Name:AL-ZOUHAYLI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:KHEIR
Other - Middle Name:
Other - Last Name:AL-ZOUHAYLI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:1639 E BIG BEAVER
Mailing Address - Street 2:104
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48083
Mailing Address - Country:US
Mailing Address - Phone:248-720-2470
Mailing Address - Fax:
Practice Address - Street 1:1639 E BIG BEAVER RD
Practice Address - Street 2:104
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48083-2053
Practice Address - Country:US
Practice Address - Phone:248-720-2470
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-20
Last Update Date:2017-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHKA062394208000000X
MIKA0623942084N0402X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0402XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology with Special Qualifications in Child Neurology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIKA062394OtherSTATE LICENSE