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General NPI Number Information
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NPI Number | 1376153726
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Entity Type | Organization
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Legal Business Name | DR. KATTIE KHADAR, PC
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Dates
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Enumeration Date | 07/31/2020
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Last Update Date | 07/31/2020
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Provider Practice Location Address
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Address Line | 6201 GREENBELT RD
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City | BERWYN HEIGHTS
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State | MD
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Zip | 20740-2354
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Country | US
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Telephone | 301-547-3939
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Fax |
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Provider Business Mailing Address
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Address Line | 6201 GREENBELT RD
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City | BERWYN HEIGHTS
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State | MD
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Zip | 20740-2354
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Country | US
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Telephone | 301-547-3939
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Fax |
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Authorized Official
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Title or Position | OWNER/DIRECTOR
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Name | DR. KATTIE KHADAR
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Credential | DNP-FNP
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Telephone | 240-481-5289
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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