Provider Demographics
NPI:1346345725
Name:KHAWLI, OSCAR FOUAD (MD)
Entity Type:Individual
Prefix:
First Name:OSCAR
Middle Name:FOUAD
Last Name:KHAWLI
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 1:8423 MARKET ST
Mailing Address - Street 2:STE 207
Mailing Address - City:BOARDMAN
Mailing Address - State:OH
Mailing Address - Zip Code:44512-6778
Mailing Address - Country:US
Mailing Address - Phone:330-729-7901
Mailing Address - Fax:330-729-7915
Practice Address - Street 1:8423 MARKET ST
Practice Address - Street 2:STE 207
Practice Address - City:BOARDMAN
Practice Address - State:OH
Practice Address - Zip Code:44512-6778
Practice Address - Country:US
Practice Address - Phone:330-729-7901
Practice Address - Fax:330-729-7915
Is Sole Proprietor?:No
Enumeration Date:2006-09-13
Last Update Date:2016-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35056095207VM0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHH149710OtherMEDICARE PTAN
OH0682560Medicaid
OHH149710OtherMEDICARE PTAN
OH0682560Medicaid