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NPI Code Detail

MEDICARE: AMBREEN KHALID MD

MEDICARE: AMBREEN KHALID 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
1207Q00000XFamily Medicine Physician111874GA
2390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1821789280
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMBREEN KHALID MD
Provider Business Mailing Address
First Line : 1000 CORPORATE CENTER DR STE 200
Second Line :
City : MORROW
State : GA
Zip : 30260-4129
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 8954 HOSPITAL DR
Second Line :
City : DOUGLASVILLE
State : GA
Zip : 30134-2272
Country : US
Telephone Number : 470-644-6000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/17/2023
Last Update Date : 06/16/2026

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