Provider Demographics
NPI:1629474721
Name:ELKADY HUSSEIN, KHALED (MD)
Entity Type:Individual
Prefix:DR
First Name:KHALED
Middle Name:
Last Name:ELKADY HUSSEIN
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 1:3226 MARY ST
Mailing Address - Street 2:G5
Mailing Address - City:MARINETTE
Mailing Address - State:WI
Mailing Address - Zip Code:54143-3168
Mailing Address - Country:US
Mailing Address - Phone:347-972-5951
Mailing Address - Fax:
Practice Address - Street 1:4061 OLD PESHTIGO RD
Practice Address - Street 2:AURORA HEALTH CENTER
Practice Address - City:MARINETTE
Practice Address - State:WI
Practice Address - Zip Code:54143-3887
Practice Address - Country:US
Practice Address - Phone:715-732-8130
Practice Address - Fax:715-732-8131
Is Sole Proprietor?:No
Enumeration Date:2014-11-17
Last Update Date:2015-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI64219 - 20207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine