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General NPI Number Information
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NPI Number | 1902283039
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Entity Type | Organization
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Legal Business Name | KHAWAR KHURSHID M D A PROFESSIONAL MEDICAL CORPORATION
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Dates
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Enumeration Date | 04/27/2015
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Last Update Date | 04/27/2015
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Provider Practice Location Address
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Address Line | 112 JAX SQ
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City | STERLINGTON
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State | LA
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Zip | 71280-3321
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Country | US
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Telephone | 646-591-0808
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Fax |
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Provider Business Mailing Address
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Address Line | 112 JAX SQ
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City | STERLINGTON
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State | LA
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Zip | 71280-3321
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Country | US
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Telephone | 646-591-0808
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. KHAWAR KHURSHID
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Credential | M.D.
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Telephone | 646-591-0808
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number | MD.206317
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License Number State | LA
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