Doctor Name: | MHD KHALED ALSHALIAN |
NPI Number: | 1679806707 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | 4301094676 |
Business Practice Address: | 81 Hillcrest Dr Suite 100 Punxsutawney, PA - 157672605 |
Business Phone Number: | 8149385910 |
Business Fax Number: | 8149384524 |
Mailing Address: | 81 Hillcrest Dr, Suite 100 PUNXSUTAWNEY |
State: | PA |
Postal Code: | 157672605 |
Phone Number: | 8149385910 |
Fax Number: | 8149384524 |
NPI Enumeration Date: | 09/08/2009 |
NPI Last Update Date: | 03/07/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 204D00000X |
License Number: | 4301094676 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Neuromusculoskeletal Medicine & OMM |
Taxonomy Specialization: | |
Taxonomy Definition: |