Healthcare Provider Details

I. General information

NPI: 1760902936
Provider Name (Legal Business Name): MUHAMMAD BILAL KHALID MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/20/2017
Last Update Date: 06/29/2023
Certification Date: 06/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 PRIDES XING STE 200
NEWARK DE
19713-6109
US

IV. Provider business mailing address

700 PRIDES XING STE 200
NEWARK DE
19713-6109
US

V. Phone/Fax

Practice location:
  • Phone: 302-998-0300
  • Fax:
Mailing address:
  • Phone: 302-998-0300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RA0201X
TaxonomyAllergy & Immunology (Internal Medicine) Physician
License NumberMD048091
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License NumberC1-0025525
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: