Provider Demographics
NPI:1720017015
Name:KAMEL, KHALED F (MD)
Entity Type:Individual
Prefix:DR
First Name:KHALED
Middle Name:F
Last Name:KAMEL
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 1:367 S GULPH RD
Mailing Address - Street 2:ATTN IPM CREDENTIALING
Mailing Address - City:KING OF PRUSSIA
Mailing Address - State:PA
Mailing Address - Zip Code:19406-3121
Mailing Address - Country:US
Mailing Address - Phone:803-502-8400
Mailing Address - Fax:803-641-7015
Practice Address - Street 1:410 UNIVERSITY PKWY STE 1520
Practice Address - Street 2:
Practice Address - City:AIKEN
Practice Address - State:SC
Practice Address - Zip Code:29801
Practice Address - Country:US
Practice Address - Phone:803-502-8400
Practice Address - Fax:803-641-7015
Is Sole Proprietor?:No
Enumeration Date:2006-07-01
Last Update Date:2020-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC217552084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC1720017015OtherBCBS OF SC
SC217553Medicaid
SC217553Medicaid
SC1720017015OtherBCBS OF SC
SCH21777Medicare ID - Type UnspecifiedMEDICARE OF SC