Provider Demographics
NPI:1679064539
Name:KAHLIL KHALAF MEDICINE
Entity Type:Organization
Organization Name:KAHLIL KHALAF MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KHALIL
Authorized Official - Middle Name:
Authorized Official - Last Name:KHALAF
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:613-898-0349
Mailing Address - Street 1:63 RUE DES MONTAGNAIS
Mailing Address - Street 2:
Mailing Address - City:GATINEAU
Mailing Address - State:QUEBEC
Mailing Address - Zip Code:J9J2M6
Mailing Address - Country:CA
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:116 LIONEL EMOND
Practice Address - Street 2:
Practice Address - City:GATINEAU
Practice Address - State:QUEBEC
Practice Address - Zip Code:J8Y1W7
Practice Address - Country:CA
Practice Address - Phone:613-898-0349
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-25
Last Update Date:2018-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Single Specialty