Provider Demographics
NPI:1447948286
Name:MOHAMMAD KHALID, PA
Entity type:Organization
Organization Name:MOHAMMAD KHALID, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MOHAMMAD
Authorized Official - Middle Name:
Authorized Official - Last Name:KHALID
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:904-217-2148
Mailing Address - Street 1:PO BOX 840009
Mailing Address - Street 2:
Mailing Address - City:ST AUGUSTINE
Mailing Address - State:FL
Mailing Address - Zip Code:32080-0009
Mailing Address - Country:US
Mailing Address - Phone:904-217-2148
Mailing Address - Fax:
Practice Address - Street 1:820 EVERGREEN AVE
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15209-2257
Practice Address - Country:US
Practice Address - Phone:904-217-2148
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-28
Last Update Date:2023-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Multi-Specialty