Provider Demographics
NPI:1710499983
Name:KHOURY, MUIN JOSEPH (MD)
Entity Type:Individual
Prefix:
First Name:MUIN
Middle Name:JOSEPH
Last Name:KHOURY
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 1:1923 MERCEDES CT NE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30345-3939
Mailing Address - Country:US
Mailing Address - Phone:404-630-6582
Mailing Address - Fax:
Practice Address - Street 1:1923 MERCEDES CT NE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30345-3939
Practice Address - Country:US
Practice Address - Phone:404-630-6582
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-27
Last Update Date:2017-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA29266208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics