Provider Demographics
NPI:1497280705
Name:KURJI, KHALIQ H (MD)
Entity Type:Individual
Prefix:MR
First Name:KHALIQ
Middle Name:H
Last Name:KURJI
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 1:1945 CEI DRIVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45242-5664
Mailing Address - Country:US
Mailing Address - Phone:513-569-3741
Mailing Address - Fax:513-569-3941
Practice Address - Street 1:1945 CEI DRIVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45242-5664
Practice Address - Country:US
Practice Address - Phone:513-569-3741
Practice Address - Fax:513-569-3941
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-24
Last Update Date:2017-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35131078207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology