Healthcare Provider Details

I. General information

NPI: 1699116491
Provider Name (Legal Business Name): HANI I ALKHATIB M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/10/2013
Last Update Date: 04/24/2026
Certification Date: 04/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 S PACA ST 7TH FLOOR, (07-022)
BALTIMORE MD
21201-1642
US

IV. Provider business mailing address

PO BOX 1671
CUMBERLAND MD
21501-1671
US

V. Phone/Fax

Practice location:
  • Phone: 410-328-7877
  • Fax:
Mailing address:
  • Phone: 240-964-8342
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberD91023
License Number StateMD
# 3
Primary TaxonomyY
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License NumberD91023
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: