Provider Demographics
NPI:1033582002
Name:ABDUL KHALID, MD, PA
Entity Type:Organization
Organization Name:ABDUL KHALID, MD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ABDUL
Authorized Official - Middle Name:S
Authorized Official - Last Name:KHALID
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-648-0241
Mailing Address - Street 1:312 W MILLBROOK RD
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27609-4389
Mailing Address - Country:US
Mailing Address - Phone:919-648-0241
Mailing Address - Fax:
Practice Address - Street 1:312 W MILLBROOK RD
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27609-4389
Practice Address - Country:US
Practice Address - Phone:919-648-0241
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-12
Last Update Date:2015-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2009-000202084P0800X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent PsychiatryGroup - Single Specialty