Provider Demographics
NPI:1306325931
Name:KHATIBI, HAMID R (MD)
Entity type:Individual
Prefix:
First Name:HAMID
Middle Name:R
Last Name:KHATIBI
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 1:730 W. MARKET ST.
Mailing Address - Street 2:
Mailing Address - City:LIMA
Mailing Address - State:OH
Mailing Address - Zip Code:45801-4667
Mailing Address - Country:US
Mailing Address - Phone:419-226-4310
Mailing Address - Fax:419-226-4315
Practice Address - Street 1:730 W. MARKET ST.
Practice Address - Street 2:
Practice Address - City:LIMA
Practice Address - State:OH
Practice Address - Zip Code:45801-4667
Practice Address - Country:US
Practice Address - Phone:419-226-4310
Practice Address - Fax:419-226-4315
Is Sole Proprietor?:No
Enumeration Date:2018-08-14
Last Update Date:2019-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.134165208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist