Provider Demographics
NPI:1346567310
Name:COMPREHENSIVE DIGESTIVE HEALTH PLLC
Entity type:Organization
Organization Name:COMPREHENSIVE DIGESTIVE HEALTH PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KHALED
Authorized Official - Middle Name:FOUAD
Authorized Official - Last Name:ELRAIE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:704-461-0161
Mailing Address - Street 1:1212 SPRUCE ST
Mailing Address - Street 2:SUITE 207
Mailing Address - City:BELMONT
Mailing Address - State:NC
Mailing Address - Zip Code:28012-3385
Mailing Address - Country:US
Mailing Address - Phone:704-461-0161
Mailing Address - Fax:
Practice Address - Street 1:1212 SPRUCE ST
Practice Address - Street 2:SUITE 207
Practice Address - City:BELMONT
Practice Address - State:NC
Practice Address - Zip Code:28012-3385
Practice Address - Country:US
Practice Address - Phone:704-461-0161
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-29
Last Update Date:2010-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200101332207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty