1225831332 NPI number — DR. ZEYAD MEDHAT KHOLEIF MBBCH

Table of content: DR. ZEYAD MEDHAT KHOLEIF MBBCH (NPI 1225831332)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1225831332 NPI number — DR. ZEYAD MEDHAT KHOLEIF MBBCH

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KHOLEIF
Provider First Name:
ZEYAD
Provider Middle Name:
MEDHAT
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MBBCH
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
KHOLEIF
Provider Other First Name:
ZEYAD
Provider Other Middle Name:
MEDHAT
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
MBBCH
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1225831332
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/01/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1040 14TH AVE SW
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ROCHESTER
Provider Business Mailing Address State Name:
MN
Provider Business Mailing Address Postal Code:
55902-2079
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
507-202-9904
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1040 14TH AVE SW
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ROCHESTER
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
55902-2079
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
507-202-9904
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/01/2025

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 390200000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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