Provider Demographics
NPI:1508611666
Name:ELNAGGAR, KHALED
Entity Type:Individual
Prefix:
First Name:KHALED
Middle Name:
Last Name:ELNAGGAR
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:JUMEIRAH BEACH RESIDENCE AMWAJ 3 APT 705
Mailing Address - Street 2:
Mailing Address - City:DUBAI
Mailing Address - State:UAE
Mailing Address - Zip Code:213859
Mailing Address - Country:AE
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4201 SAINT ANTOINE ST # 9C
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48201-2153
Practice Address - Country:US
Practice Address - Phone:313-745-5146
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-22
Last Update Date:2024-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program