Provider Demographics
NPI:1013179654
Name:ELNAGAR, KHALID ABDELSALAM (MD)
Entity Type:Individual
Prefix:DR
First Name:KHALID
Middle Name:ABDELSALAM
Last Name:ELNAGAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 751069
Mailing Address - Street 2:ECU PHYSICIANS
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28275-1069
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:905 JOHNS HOPKINS DR
Practice Address - Street 2:ECU PHYSICIANS PSYCHIATRIC OUTPATIENT CENTER
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834-2056
Practice Address - Country:US
Practice Address - Phone:252-744-1406
Practice Address - Fax:252-744-4243
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-25
Last Update Date:2015-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2623432084P0800X
NC2015-017482084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1013179654Medicaid
NC19D6EOtherBCBS NC
NYAA-11156482598OtherID NUMBER AT ALBANY MEDICAL CENTER
NC19D6EOtherBCBS NC