Provider Demographics
NPI:1346829173
Name:KHEDER, KAMRAN (MD)
Entity Type:Individual
Prefix:MR
First Name:KAMRAN
Middle Name:
Last Name:KHEDER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:KAMRAN
Other - Middle Name:
Other - Last Name:KHEDERZADEH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2031 BELMONT AVE
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44505-2401
Mailing Address - Country:US
Mailing Address - Phone:330-480-3605
Mailing Address - Fax:330-480-2948
Practice Address - Street 1:2031 BELMONT AVE
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44505-2401
Practice Address - Country:US
Practice Address - Phone:330-480-3605
Practice Address - Fax:330-480-2948
Is Sole Proprietor?:No
Enumeration Date:2021-04-07
Last Update Date:2023-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH57.251807207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine