Healthcare Provider Details

I. General information

NPI: 1407474000
Provider Name (Legal Business Name): SUALEHA KHALID MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/09/2020
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1140 BLADES FARM RD STE 103
DENTON MD
21629-3488
US

IV. Provider business mailing address

219 S WASHINGTON ST
EASTON MD
21601-2913
US

V. Phone/Fax

Practice location:
  • Phone: 410-479-5900
  • Fax:
Mailing address:
  • Phone: 410-822-1000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License NumberD0106456
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: