Healthcare Provider Details

I. General information

NPI: 1578204756
Provider Name (Legal Business Name): HUZAIFA KHALID MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/05/2022
Last Update Date: 04/14/2026
Certification Date: 04/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 E CARROLL ST
SALISBURY MD
21801-5422
US

IV. Provider business mailing address

43172 FLEUR DR
LEESBURG VA
20176-5015
US

V. Phone/Fax

Practice location:
  • Phone: 410-546-6400
  • Fax:
Mailing address:
  • Phone: 571-223-8764
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberD0102718
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberD0102718
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: