Provider Demographics
NPI:1972869717
Name:ALKHATIB, FADI H (DO)
Entity type:Individual
Prefix:DR
First Name:FADI
Middle Name:H
Last Name:ALKHATIB
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2001 WESTOWN PKWY STE 107
Mailing Address - Street 2:
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50265-1540
Mailing Address - Country:US
Mailing Address - Phone:515-223-8622
Mailing Address - Fax:515-223-5324
Practice Address - Street 1:2001 WESTOWN PKWY STE 107
Practice Address - Street 2:
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50265-1540
Practice Address - Country:US
Practice Address - Phone:515-223-8622
Practice Address - Fax:515-223-5324
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-05
Last Update Date:2023-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA262827207R00000X, 208M00000X
390200000X
IADO-05403207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program