Healthcare Provider Details

I. General information

NPI: 1225889827
Provider Name (Legal Business Name): KHAWER SAEED MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/01/2024
Last Update Date: 04/01/2024
Certification Date: 03/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

154 LEMARCHANT ROAD NL
ST. JOHN'S NL
A1C5B8
CA

IV. Provider business mailing address

11808 HOGANS ALY
CHESTER VA
23836-2662
US

V. Phone/Fax

Practice location:
  • Phone: 709-777-5000
  • Fax:
Mailing address:
  • Phone: 407-799-0980
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number0101266034
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: