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113 Cedar St S East Canton OH 44730-1305 | |
| (330) 488-0767 | |
| (330) 488-2907 |
| Full Name | |
|---|---|
| Speciality | Internal Medicine |
| Location | 113 Cedar St S, East Canton, Ohio |
| Authorized Official Name and Position | Amin Youssef Khalil (PRESIDENT) |
| Authorized Official Contact | 3308779388 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
113 Cedar St S Po Box 30170 East Canton OH 44730-1305 Ph: (330) 488-0767 | 113 Cedar St S East Canton OH 44730-1305 Ph: (330) 488-0767 |
| NPI Number | 1033174024 |
|---|---|
| Provider Enumeration Date | 04/20/2006 |
| Last Update Date | 05/02/2012 |
| Medicare PECOS PAC ID | 8820054307 |
|---|---|
| Medicare Enrollment ID | O20041207000117 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033174024 | NPI | - | NPPES |
| 2621201 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Amin Youssef Khalil |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1700867959 PECOS PAC ID: 0446213417 Enrollment ID: I20041215000074 |