Healthcare Provider Details

I. General information

NPI: 1205890258
Provider Name (Legal Business Name): AMATUL BASIT KHALID MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/14/2006
Last Update Date: 04/10/2023
Certification Date: 04/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

124 SLEEPY HOLLOW DR STE 203
MIDDLETOWN DE
19709-5838
US

IV. Provider business mailing address

124 SLEEPY HOLLOW DR STE 203
MIDDLETOWN DE
19709-5838
US

V. Phone/Fax

Practice location:
  • Phone: 302-449-3030
  • Fax: 302-449-3040
Mailing address:
  • Phone: 302-449-3030
  • Fax: 302-449-3040

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License NumberMD063751L
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD063751L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: