Healthcare Provider Details

I. General information

NPI: 1154992790
Provider Name (Legal Business Name): SADORI KHAWAJA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/06/2021
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 PLEASANT ST
DES MOINES IA
50309-1406
US

IV. Provider business mailing address

1200 PLEASANT ST
DES MOINES IA
50309-1406
US

V. Phone/Fax

Practice location:
  • Phone: 515-241-6425
  • Fax:
Mailing address:
  • Phone: 515-241-6425
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number2021016223
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License NumberBP10086890
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: