1699809715 NPI number — MUHAMMAD A. KHALID, DPM,PC

Table of content: (NPI 1699809715)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1699809715 NPI number — MUHAMMAD A. KHALID, DPM,PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MUHAMMAD A. KHALID, DPM,PC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
ANACOSTIA FOOT CENTER
Provider Other Organization Name Type Code:
5
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1699809715
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/21/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2041 MARTIN LUTHER KING JR AVE SE
Provider Second Line Business Mailing Address:
SUITE 103
Provider Business Mailing Address City Name:
WASHINGTON
Provider Business Mailing Address State Name:
DC
Provider Business Mailing Address Postal Code:
20020-7024
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
202-889-6020
Provider Business Mailing Address Fax Number:
202-889-6021

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2041 MARTIN LUTHER KING JR AVE SE
Provider Second Line Business Practice Location Address:
SUITE 103
Provider Business Practice Location Address City Name:
WASHINGTON
Provider Business Practice Location Address State Name:
DC
Provider Business Practice Location Address Postal Code:
20020-7024
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
202-889-6020
Provider Business Practice Location Address Fax Number:
202-889-6021
Provider Enumeration Date:
03/14/2007

Additional Information

Authorized Official

Authorized Official Last Name:
KHALID
Authorized Official First Name:
MUHAMMAD
Authorized Official Middle Name:
A
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
202-889-6020

Provider Taxonomy Codes

  • Taxonomy code: 213E00000X , with the licence number:  P0478 , registered in the state of DC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 12107 . This is a "CHARTERED HEALTH PLAN" identifier , issued by the state of ( DC ) . This identifiers is of the category "OTHER".
  • Identifier: 000594594 . This is a "APWU" identifier , issued by the state of ( DC ) . This identifiers is of the category "OTHER".
  • Identifier: 08508 . This is a "AMERIGROUP" identifier , issued by the state of ( DC ) . This identifiers is of the category "OTHER".
  • Identifier: 4151 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( DC ) . This identifiers is of the category "OTHER".
  • Identifier: 246484MD2 . This is a "M.D. IPA" identifier , issued by the state of ( DC ) . This identifiers is of the category "OTHER".
  • Identifier: 026584500 , issued by the state of ( DC ) . This identifiers is of the category "MEDICAID".




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