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Contact Information

WISSAM E KHOURY, DPM
2351 E 22ND ST
CLEVELAND, OH44115
 Phone: 216-367-9444
 Fax: 216-453-0331
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Podiatrist

213E00000X 48 Podiatry
Indicates primary specialty

NPI Profile & details for WISSAM E KHOURY · (Male)

NPI # 1104886910
Status Active
Credentials DPM (Doctor of Podiatric Medicine)
Entity Individual
Enumeration date 03/24/2006
Last updated 03/22/2016 - About 10 years ago
Sole proprietor 1 No
Identifiers
  • OH License # 36003289
  • OH Medicaid 2487116
Hospital affiliation(s)
  • ST VINCENT CHARITY MEDICAL CENTER - (Acute Care)
    2351 EAST 22ND STREET
    CLEVELAND, OH 44115
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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