MEDICARE: DR. KHALID EL-BEDAWI MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	D0067569	MD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1013093954
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KHALID EL-BEDAWI MD

Provider Business Mailing Address
First Line	:	5038 TEN MILLS RD
Second Line	:
City	:	COLUMBIA
State	:	MD
Zip	:	21044-1528
Country	:	US
Telephone Number	:	443-540-4474
Fax Number	:

Provider Business Practice Location Address
First Line	:	1515 W NORTH AVE
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21217-1735
Country	:	US
Telephone Number	:	410-383-8300
Fax Number	:	443-383-3160

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/31/2006
Last Update Date	:	11/01/2019

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