Provider Demographics
NPI:1679806707
Name:ALSHALIAN, MHD KHALED (MD)
Entity type:Individual
Prefix:
First Name:MHD KHALED
Middle Name:
Last Name:ALSHALIAN
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 1:5300 NORTH MEADOWS DRIVE
Mailing Address - Street 2:BUILDING 1, SUITE 140
Mailing Address - City:GROVE CITY
Mailing Address - State:OH
Mailing Address - Zip Code:43123-2546
Mailing Address - Country:US
Mailing Address - Phone:614-627-1620
Mailing Address - Fax:614-224-4428
Practice Address - Street 1:5300 NORTH MEADOWS DRIVE
Practice Address - Street 2:BUILDING 1, SUITE 140
Practice Address - City:GROVE CITY
Practice Address - State:OH
Practice Address - Zip Code:43123-2546
Practice Address - Country:US
Practice Address - Phone:614-627-1620
Practice Address - Fax:614-224-4428
Is Sole Proprietor?:No
Enumeration Date:2009-09-08
Last Update Date:2022-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.1359912084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology