Healthcare Provider Details

I. General information

NPI: 1639270739
Provider Name (Legal Business Name): RADHIKA KHWAJA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/25/2006
Last Update Date: 09/17/2025
Certification Date: 09/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

508 FULTON ST # 111G
DURHAM NC
27705-3875
US

IV. Provider business mailing address

508 FULTON ST # 111G
DURHAM NC
27705-3875
US

V. Phone/Fax

Practice location:
  • Phone: 919-286-0411
  • Fax:
Mailing address:
  • Phone: 919-286-0411
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number200200133
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: