Leila Khaddour, MD
Internal Medicine, Medical Oncology in Caldwell, ID. Individual provider (NPI-1).
NPI number1750797486
StatusActive
Last updated in NPPESJul 21, 2022
Details
- NPI
- 1750797486
- Entity type
- Individual (NPI-1)
- Name
- Leila Khaddour
- Credential
- MD
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jul 2, 2014
- Certification date
- Sep 18, 2020
- Last updated
- Jul 21, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207RX0202X | Internal Medicine, Medical Oncology | MC-0480 | ID | Yes |
| 207R00000X | Internal Medicine | 4301105339 | MI | |
| 207RX0202X | Internal Medicine, Medical Oncology | 4301105339 | MI |
Practice location
3123 Medical DrCaldwell, ID 83605-6972
Phone 208-367-3131 · Fax 208-367-4817
Mailing address
3340 E Goldstone DrMeridian, ID 83642-1026
Phone 208-367-5170 · Fax 208-367-5180
Other practice locations
2799 W Grand Blvd
Detroit, MI 48202-2608
Detroit, MI 48202-2608
Phone 313-916-2600
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