MEDICARE: DR. ABDUL S 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
1	2084P0804X	Child & Adolescent Psychiatry Physician	2009-00020	NC
2	2084P0800X	Psychiatry Physician	2009-00020	NC

General Provider Information

NPI Number	:	1942492509
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ABDUL S KHALID MD

Provider Business Mailing Address
First Line	:	2000 PERIMETER PARK DR STE 200
Second Line	:
City	:	MORRISVILLE
State	:	NC
Zip	:	27560-8442
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	208 COX BLVD STE 100
Second Line	:
City	:	GOLDSBORO
State	:	NC
Zip	:	27534-9414
Country	:	US
Telephone Number	:	919-587-4051
Fax Number	:	919-580-1083

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

Provider Enumeration Date	:	08/16/2007
Last Update Date	:	05/10/2021

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