Healthcare Provider Details

I. General information

NPI: 1093750754
Provider Name (Legal Business Name): WEDAD MOHAMMED KHEDR M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/18/2006
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1738 OWEN DR STE 107
FAYETTEVILLE NC
28304-3880
US

IV. Provider business mailing address

PO BOX 617
SOMERTON AZ
85350-0617
US

V. Phone/Fax

Practice location:
  • Phone: 910-739-3318
  • Fax:
Mailing address:
  • Phone: 928-315-7910
  • Fax: 928-722-6113

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number036091500
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number202602758
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: